CDHC Solutions Mar/Apr 11 by The Institute for HealthCare Consumerism

Spotlight on CDHC Solutions forum East and West Conferences

WWW.CDhCsOLUTiONsMAg.COM

MArCh/ApriL 2011

VOL 7 NO. 3

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Embracing Long-term Strategy

by Reducing Cost, Promoting Cultural Change online Care: Bringing health Care Directly to employees at home, Work Consumer-directed health Care Movement Continuing to Gain Momentum Supplemental insurance Polices can help increase CDhP Participation

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FEAturEs

28 embracing Long-term Strategy by

reducing Cost, Promoting Cultural Change Eager to reduce employee health risks, control costs and continue to develop a culture of positive change, Jagemann Stamping Company, the leading manufacturer of deep drawn metal stampings, began exploring consumer-driven health care options, including implementing a wellness program. The company teamed with Trotter Wellness and selected HSA Bank as HSA administrator. In the first year, Jagemann saw its average medical claims drop by more than 40 percent

inSiDe

33 Consumer-Directed health

Care Movement Continuing to gain Momentum Over the last five years, health savings accounts and health reimbursement accounts have grown 375 percent. Lighthouse1 clients Ceridian Corporation and HealthSCOPE Benefits have both embraced CDHC plans and have witnessed their sales escalate. By Jeff Bakke

By Patrick trotter

36 online Care: Bringing health Care Directly to employees at Work, home

While consumers have enjoyed the convenience of online banking, shopping and online travel booking, employees are now enjoying the same convenience through Online Care, a service offering the ability to come together with health care providers for immediate, live conversations using video, secure text chat or phone. By Roy Schoenberg

COMiNg Up NEXT: Johnson & Johnson’s Wellness & Prevention showcases innovative strategies to reduce health care costs during health care reform; Aflac presents Benefits’ Rules of Engagement: Education, Communication,” and Liazon showcases a better practice on engaging employees. ON ThE COVEr: Jagemann Stamping Company CEO Thomas M. Jagemann, right, works with a fellow employee on the factory floor in Manitowoc, Wis. In the first year of offering an HSA, Jagemann had 60 percent of its workforce participate in the program. www.cdhcsolutionsmag.com I CDHC Solutions™ I March/April 2011

DePartMentS 6

editor & Publisher’s Letter

health Care Consumerism

oNlINE CdhC solutions online brings you Web 2.0 at its best—a social networking site dedicated to providing expert advice, trends, and information about consumer-directed health care using a 24/7, virtual, portable format.

time to Nominate Your Company’s superstars happy birthday obamaCare

By ronald e. Bachman

11 CDhC Solutions Forum

health care delivery and benefit design are changing at a frenetic pace. Are you successfully navigating the shifting paradigm? learn how on CdhCsolutionsMag.com.

Agenda for Forum East in Atlanta ■ registration for Forum East and West ■ Featured speakers ■

WEb-oNlY FEAturEs health Care Consumerism

16 tribute

loving tribute to a Friend, Industry leader

16 innovations

Can Health Care Handle the Passing Lane?

sCIoinspire launches Just Intime Wellness App on benefitfocus Platform ■ Medco’s Willingboro Automated Pharmacy: 500 Million Prescriptions and Counting ■

By kyle Rolﬁng, RedBrick Health

hSa/hra/FSa admin & Finance Health Risk Assessments: A Waste of Time and Money

18 People on the Move/Briefs

By Lisa Holland, Simplicity Health plans

health Plans/Managed Care

dataPath Names John robbins, Jr. President, CEo

2011 Economic Health Care Trends

By Jane Cooper, patient Care

21 hSa/FSa/hra admin & Finance

Policy & Legislation

hsAs: An unlikely survivor of health, Financial reform

obamaCare’s March Madness By grace-Marie Turner, Alex Cortes, Heather R. Higgins

By E. Craig keohan

23 health Plans – Self Funding

Social networking

self Funding, Pricing transparency Will become More Popular due to health Care reform

tweet tweet

By Rob Thurston

Follow CdhC solutions on twitter, @ cdhcsolutions, to stay in the loop with latest health care reform news and industry updates.

25 Population health & Wellness

Is Your Culture of Wellness really Working?

Facebook

By peter Saravis

Fan CdhC solutions on Facebook to connect with other CdhC followers and get recent site postings from our wall feeds.

27 Supplemental health

supplemental Insurance Policies can help Increase Consumer-driven health Plan Participation By Thomas R. giddens

Featured Blog

Welcome to the New broker

41 ask Your Broker

Why should an Employer Ask for a defined Contribution Plan?

by New broker

event

By Josh Hilgers

46 Who’s Who Profiles

The 2011 CDhC Solutions Forum our Conference has expanded with Forum EAst in Atlanta, GA., May 11-12, and our inaugural Forum WEst in denver, Co., on sept. 15. www.cdhcsolutionsmag.com/forum/

50 resource guide/ad index

have something to share? Post a blog or forum on www.cdhcsolutionsmag.com today!

42 Stats & Data

CdhPs: A timely solution By Chris Riedl

Print anD onLine KeY Connect with CdhC experts and community members online at www.CdhCsolutionsMag.com by looking for the following symbols at the end of each article: blog

MEMBER

BLOG

WHO’S WHO PROFILE

BROKER/ADVISOR/ CONSULTANT

EMPLOYEE COMMUNICATION & EDUCATION

HEALTH PLANS

HSA/HRA/FSA ADMIN & FINANCE

S TOTAL POPULATION HEALTH & WELLNESS

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March/April 2011 I CDHC Solutions™ I www.cdhcsolutionsmag.com

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Editor & Publisher www.cdhcsolutionsmag.com

Time to Nominate Your Company’s Superstars

With the winter of our discontent giving way to the hopes and positive vibe of spring, so to does the economy, continuing its slow but steady climb. That positive energy is evident in this issue of CDHC Solutions, the leading voice of health care consumerism. Employers have weathered the storm of downsizing and budget cuts and are beginning to see the light at the end of the tunnel. They have had to tighten their belts during these rocky times, and a victim of the budget cuts has usually been in employee health and benefits. Those benefit managers, who foresaw what was happening and were able to maintain the company’s health and benefits programs, as well as a health and wellness program, were cogs in the success and well-being of the company. With employee loyalty at an all-time low, according to ninth annual Study of Employee Benefits Trends, released by MetLife, employers, lulled to sleep by the sluggish economy and low-employee turnover, could face a mass exodus, as employees are no longer happy to just have a job. Benefits remain an important mechanism to support business goals of employee attraction, retention and productivity. Benefits forge an employer-employee bond by helping to financially protect employees and their families. This puts added pressure on the employer, HR/Benefits executive or team, who have weathered the storm and emerged stronger now than prior to the recession. For those unsung heroes, CDHC Solutions is proud to present our sixth annual Solutions Superstars 2011, slated for publishing in December. This year’s Superstars promises to be the largest edition in the history of FieldMedia, as we expand to 11 award categories. This year we debut the John J. Robbins Sr., Memorial CEO Leadership Award, in honor of the former DataPath founder and president, who passed away unexpectedly in February due to complications from Hodgkin’s lymphoma. This inaugural award will be given to a company CEO, who has shown a commitment to the health care industry and an a organizational leader, who also is considered a pillar of the community and dedicated to family. The other two inaugural awards are the Most Innovative Employee Empowerment Award and the Public Policy Leadership Award. The other eight awards are: CEO Leadership Award; Most Innovative Health and Benefits Plan Design Award; Most Effective Health and Benefits Plan Implementation Award; Most Innovative Employee Education/Communication Award; Most Effective Population Health & Wellness Award; Innovator Award; Most Innovative Partner-Consultant Award and Most Innovative Broker Award. Nominations are now open and can be e-mailed to nominations@fieldmedia.com or nominations can be recorded online at www.cdhcsolutionsmag.com or www.employersweb.com. For more information, please see our ad on Page 34. Nominations close Sept. 30. We hope you enjoy this edition of CDHC Solutions, and we look forward to seeing you at CDHC Solutions Forum East at the Cobb Galleria Centre on May 11-12. For more information and to register go to www.cdhcsolutionsforum.com. Sincerely,

VOLUME 7 NO. 3 March/April 2011

Published by FieldMedia LLC 292 South Main Street, Suite 400 Alpharetta, GA 30009 Tel: 404.671.9551 Fax: 770.663.4409 ceo/ Publisher/Editor-In-Chief

Doug Field 404.671.9551 ext. 101 · dfield@ fieldmedia.com Associate Publisher

Brent Macy 404.671.9551 ext. 103 · bmacy@fieldmedia.com Managing Editor

Todd Callahan 404.671.9551 ext. 105 · tcallahan@fieldmedia.com Associate Editor

Jonathan Field jfield@fieldmedia.com Sales Associates National Account Manager

Brent Macy 404.671.9551 ext. 103 · bmacy@fieldmedia.com Vice President of Business Development

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David Cerri 404.671.9551 ext. 106 · dcerri@fieldmedia.com Rogers Beasley 404.671.9551 ext. 109 · rbeasley@fieldmedia.com art director

Kellie Frissell 404.671.9551 ext. 107 · kfrissell@fieldmedia.com Chairman of CDHC Solutions Editorial Advisory Board

Ronald E. Bachman, CEO, Healthcare Visions Editorial Advisory Board

Ronald E. Bachman, Healthcare Visions G.J. Domis, Procter & Gamble Tracy Grunsfeld, Medco Health Solutions Karen Kirkpatrick, Infinisource Mike McCue, former editor-in-chief, Managed Health Care Executive Joseph Paduda, Health Strategy Associates David Randall, CDHCI Janet Trautwein, National Association of Health Underwriters Neil Trautwein, National Retail Federation Andrew Webber, National Business Coalition on Health Online Content Manager

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Tom Becher webmaster@fieldmedia.com CDHC Solutions ™ Volume 7 Issue 3 Copyright ©2010 by FieldMedia LLC. All rights reserved. CDHC Solutions ™ is a trademark of FieldMedia LLC. CDHC Solutions ™ is published eight times yearly by FieldMedia, Inc., 292 South Main Street, Suite 400, Alpharetta, GA 30009. Periodical postage paid at Alpharetta, GA and additional mailing offices. TO SUBSCRIBE: Make checks and money orders payable to CDHC Solutions ™ magazine 292 S. Main Street, Suite 400, Alpharetta, GA 30009 or visit www.cdhcsolutionsmag.com. Non-qualified persons may subscribe at the following rates: single copy $7.50; $75.00/yr in the US, $105/yr in Canada and $170/yr international. Please contact FieldMedia at 404.671.9551 or subscriberservice@fieldmedia.com for name/address changes.

Todd Callahan Managing Editor tcallahan@fieldmedia.com

March/April 2011 I CDHC Solutions™ I www.cdhcsolutionsmag.com

Doug Field CEO/Publisher dfield@fieldmedia.com

PRINTED IN THE U.S.A. CDHC Solutions ™ is designed to provide both accurate and authoritative information with regard to the understanding that the publisher is not engaged in rendering legal, financial or other professional service. If legal advice is required, the services of a professional adviser should be sought. The magazine is not responsible for unsolicited manuscripts or photographs. Send letters to the editor and editorial inquiries to the above address or to mbolch@fieldmedia.com. Requests for Permissions to reuse content contact Copyright Clearance Center at info@copyright.com.

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Health Care Consumerism

Happy Birthday ObamaCare

he Patient Protection and Affordable Care Act (PPACA), known as ObamaCare, was signed into law on March 23, 2010. Since its passage, the bill remains unpopular with the general public, a core fiscal concern for many voters, and many are discovering its government mandates are intrusive. Supporters believed once passed, the law would gain in popularity. It has not. It is currently the “law of the land,” but it may not be for long. On Jan. 31, Senior United State District Court Judge Roger Vinson ruled the individual mandate in the PPACA was unconstitutional. He further stated the entire bill was unconstitutional because the act lacked a “severability clause.” Severability clauses are typically part of any major legislation. The purpose of a severability clause is to assure if any portion of an act is found in violation of other laws (or unconstitutional) only that section of the act is voided. But Congress purposefully deleted the severability clause from an earlier version of the health reform legislation. The PPACA is a unified whole. The Congressional structure and the legal arguments from the Department of Justice (DOJ) are the act stands or falls as a single entity. The DOJ is appealing the ruling to the 11th Circuit Court of Appeals. DOJ attorneys had until April 4 to file their appeal, and those challenging the PPACA have until May 4 to respond. Usually a three-judge panel hears an appeal, but five of the state attorneys general are asking for the entire Appellate Court hear the case. A broader hearing could accelerate progress to the U.S. Supreme Court, which will ultimately decide the case. This could probably occur during the 2012 election campaign. Judge Vinson’s ruling was both simple and academic, historically referenced and legally founded in precedence. The “CliffNotes” version of the arguments and the rulings are easy for any non-lawyer to understand. Those in favor of ObamaCare argued the government can require the purchase of private health insurance under the Commerce Clause of the U.S. Constitution. They argued previous court rulings allowed the federal government to regulate business transactions across state lines and even those within a state that could have financial impact across state lines. Those opposed to the PPACA argued the Commerce Clause does not apply and that the government cannot force individuals to purchase a private product of any type. Judge Vinson boiled it down to a very simple concept: The government can regulate commercial “activity” under the Commerce Clause (he pointed to broad but limiting standards), but it cannot regulate “inactivity.” He stated an individual’s decision not to purchase private health insurance is inactivity. One cannot be regulated or penalized for inactivity. Therefore, the individual mandate has no basis in our constitution. While Judge Vinson intimated the goal of health reform is laudable, his role was to determine the constitutionality of the act. He observed there are many ways to accomplish health reform. His ruling stated: “On this point, it should be emphasized that while the individual mandate was clearly ‘necessary and essential’ to the Act as drafted, it is not ‘necessary and essential’ to health care reform in general. It is undisputed that there are various other (Constitutional) ways to accomplish what Congress wanted to do.”

He stated an individual’s decision not to purchase private health insurance is inactivity. One cannot be regulated or penalized for inactivity. Therefore, the individual mandate has no basis in our constitution. In ruling against the individual mandate, Judge Vinson quoted President Obama’s own words, “…in 2008, then-Senator Obama supported a health care reform proposal that did not include an individual mandate because he was at that time strongly opposed to the idea, stating that ‘if a mandate was the solution, we can try that to solve homelessness by mandating everybody to buy a house.’ ” The role Judge Vinson took was not to determine the rightness, wrongness, or valuable ends of the legislation; his role was to apply the constitution which protects not only individuals from individuals, but individuals from government. His ruling concluded the individual mandate was an over-reach of the government’s constitutional authority to rule the lives of Americans. He quoted James Madison, who once observed: If men were angels, no government would be necessary. If angels were to govern men, neither external nor internal controls on government would be necessary. In framing a government which is to be administered by men over men, the great difficulty lies in this: You must first enable the government to control the governed; and in the next place oblige it to control itself. On this first birthday of ObamaCare, it is still uncertain whether or not it will survive legal and legislative challenges. Candidate Obama once stated he would not sign a health reform bill unless it included broad bipartisan support. Once elected president, he encouraged its passage using political sweetheart deals, arcane parliamentary maneuvers, and ultimately signed the most divisive partisan major bill in our country’s history. During this ObamaCare birthday period, he may be fighting the opposition with a “let them eat birthday cake” attitude, but this may be one present that gets returned. You can keep up with legal challenges and the rapid regulatory implementation releases from multiple sources at www. CDHCSolutionsMag-HRN.com. Rnald E. Bachman FSA, MAAA, is president and CEO of Healthcare Visions Inc. He is a senior fellow at the Center for Health Transformation, the Georgia Public Policy Foundation, the Wye River Group on Health, and the National Center for Policy Analysis. Ronald is the chair of the editorial advisory board of CDHC Solutions and can be reached at ronbachman@healthcarevisions.net.

www.cdhcsolutionsmag.com I CDHC Solutions™ I March/April 2011

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FI N ANCIAL S OLUT IONS

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PAYMENT SOL UTION S HEALTHCARE

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BU SI N E SS C O N SU LTI N G

•

TE C H N O LO G Y SE RVI CES

SUccEEd in A tiME oF UncErtAinty Understand the health care laws. Manage better health & benefit choices. Empower your employees.

Featured Speakers Ron Bachman

FSA, MAAA, Sr. Fellow, Center for Health Transformation; President, Healthcare Visions; Chairman of CDHC Solutions Editorial Advisory Board

Roy Ramthun

Tom Torre

Jon Comola

SVP General Manager, FIS Consumer Driven Healthcare Solutions, FIS Global

President, HSA Consulting Services, LLC; Former Senior Health Policy Advisor to President George W. Bush

CEO and Chairman, Wye River Group; Founder of Foundation for American Healthcare Leadership

John Hickman

John Young

Vice President â&#x20AC;&#x201C; Consumerism CIGNA HealthCare

Partner, Alston+Bird LLP

www.cdhcsolutionsforum.com Who Should Attend?

CEOs/Presidents/CFOs HR and benefits executives Health plan administrators Corporate wellness and medical directors Benefit brokers Third party administrators Benefit consultants Bankers

www.cdhcsolutionsforum Benefits of Attending The 2nd Annual CDHC Solutions Forum conference series, produced by CDHC Solutions magazine, is designed for employers, TPAs, benefit brokers, consultants and regional health plan providers seeking strategies to enhance their current health and benefit offerings, and the tools to implement them. The conferences are focused on consumer-directed health care, including: • Pharmacy benefit management • Population health and wellness strategies • Employee incentives and communications • HSA/HRA/FSA administration • New health care law Featured speakers and top industry leaders will share valuable information and experiences that you cannot afford to miss.

You will walk away knowledgeable, inspired and prepared to implement new health care strategies to save your company time and money. It is our pleasure to host this conference series. We thank you for your participation and we continue to pledge unmatched dedication to integrity and knowledge in the industry through our forums, publications and online communities.

Doug Field President, Publisher, CEO FieldMedia LLC

Ron Bachman, FSA, MAAA Chairman CDHC Solutions Editorial Advisory Board

FORUM EAST 2011

Atlanta

2011 Conference Locations Forum East 2011, May 11-May 12 Atlanta, GA Cobb Galleria Centre New for 2011, the East Forum has expanded to a day and a half with six featured speakers, eighteen workshops and two pre-conference workshops. Plan to attend one of the pre-conference workshops (additional fees apply) for hands-on, exclusive health and benefit solutions.

Forum West 2011, September 15 Denver, CO Marriott Tech Center

Pre-Conference Workshops: • Health Care Reform: What Happened? What is to Come and What is Still Needed? Includes a complimentary one year, full subscription to the Health Reform Navigator (a $99 value) •

CDHC Certification Course, brought to you by NAHU (National Association of Health Underwriters) Approved for insurance continuing education credits

Visit www.cdhcsolutionsforum.com to preview the agenda and register for the conference.

New for 2011, the Forum West conference will be held in Denver, CO. The West Forum will include six featured speakers, eight workshops and an interactive employer panel. Visit our website to view the latest agenda.

Take advantage of our Early Bird rates by registering before 7/29. Go to www.cdhcsolutionsforum.com.

FORUM WEST 2011

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SUCCEED IN A TIME OF UNCERTAINTY

It’s not too late to register! Special Savings Rate Until 5/4/11

Super Saver Rate Until 5/4/11 Early Bird Rate Until 7/29/11

Forum East: Attendee conference registration includes: • Three innovative workshops of your choice • Four general sessions with top industry leaders • Continental breakfast, all-day breaks and boxed lunch • Opening night reception • Conference workbook with all presentations • Free parking

Forum West: Attendee conference registration includes: • Two innovative workshops of your choice • Three general sessions with top industry leaders • Continental breakfast, all-day breaks and boxed lunch • Conference workbook with all presentations

Group rates are available for both events. Register at www.cdhcsolutionsforum.com. Dress for the conference is business casual.

Gold Sponsors

Silver Sponsors & Exhibitors

Partnered with

Produced by CDHC Solutions,™ a FieldMedia Property

2 0 1 1 C o n f erence E A S T A g enda

WEDNESDAY MAY 11 8:30 – 12:00 p.m. 8:00 – 1:00 p.m. 1:00 – 2:45 p.m. 2:45 – 3:00 p.m. 3:00 – 4:00 p.m. 4:15 – 5:15 p.m.

5:15 – 7:00 p.m.

Pre-Conference Hands-On Workshops (additional fee) 1 – Health Care Reform: What Happened, What is to Come and What is Still Needed 2 – CDHC Certification Course Registration Opening RemarksOpening General Session”The Expanding Future of Health Care Consumerism” Afternoon Break and Exhibits Open Track #1 Workshop – Choose one (1) A – Missing the Mark in Specialty Health Benefits Education B – Consumer-centric Employee Benefits: Economics 101 C – Who Survives? How Benefit Costs are Killing your Company D – Utilizing Rewards and Incentives to Influence Decisions on Improved Health E – How to Educate, Engage and Empower Health Care Consumers while Achieving Corporate Finance and Wellness Objectives F – CDHP and Health Reform Strategy – A Total Replacement HSA Case Study Closing General Session Day One – “Implementing Health Care Reform: “Implementing Health Care Reform: The Year in Review and What’s on the Horizon for CDHC” Opening Night Reception in Main Ballroom

THURSDAY MAY 12 7:30 – 9:00 a.m. 9:00 – 10:30 a.m. 10:30 – 11:00 a.m. 11:00 – 12:00 p.m. 12:00 – 1:30 p.m. 1:30 – 2:30 p.m. 2:30 – 2:45 p.m. 2:45 – 3:45 p.m. 3:45 – 4:15 p.m. 4:15 – 5:15 p.m.

Registration and Continental Breakfast, Exhibits Open General Session – “Impact of Health Reform on Health Care Consumerism: A Multi Stakeholder View” Morning Break and Exhibits Open Track #2 Workshops – Choose one (1) G – Personal. Social. Financial. How to Drive Sustained Engagement in Health H – Cost Transparency: What Can Make CDHC Truly Work I – How CDHC Positioned Zions Bancorp Well Under Health CareReform aka PPACA J – Consumer-Centric Behavior Treatments K – Improving Employee Participation and Engagement L – Value Based Design Fuels Patient Engagement Lunch in Main Ballroom, Exhibits Open Afternoon General Session – “Population Health & Wellness Panel” Beverage Break Track #3 Workshops – Choose one (1) M – Innovation for Self Funded Plans, Ways to Save Money on RX and Recapture Provider Overpayments on Claims N – The ABC’s of HRA to Predict and Manage Medical Risk O – Upgrading Health and Wellness Incentive Programs P – What Health Reform Means to COBRA Q – 5 Questions You Should be Asking about your Current or Planned BenAdmin R – CDHP: Advanced Plan Design Afternoon Break and Exhibits Open Closing General Session – Employer Panel “How Employers are Moving to Health Care Consumerism and Addressing the Health Care Law”

For the latest updates and to register, visit www.cdhcsolutionsforum.com or call 404.671.9551.

PRICING – 2011 EAST Type

Onsite

Employer: Government

$495

$695

Employer: Private Sector

$595

$895

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REGISTRATION

Standard • 5/10/11

*Group Rates Available 25% off – Two or More

Attendee Pricing Includes • Continental Breakfast, all-day breaks and Boxed Lunch • Three Innovative Workshops of your choice • Four General Sessions with the Top Industry Leaders • Opening Night Reception • Conference Notebook with all Presentations

Tom Torre SVP/General Manager, FIS Consumer Driven Healthcare Solutions FIS Global John Young Vice President-Consumerism, CIGNA HEALTHCARE

Roy Ramthun An expert on Health Savings Accounts and consumerdirected health care issues. Jon Comola CEO and Chairman, Wye River Group and Founder of Foundation for American Healthcare Leadership

John Hickman Partner, Alston+Bird LLP

Doug Field CEO, FieldMedia LLC, Publisher of CDHC Solutions and Producers of CDHC Solutions Forum

Josh Hilgers An expert in consumerdriven health care and the communication of these plan designs and owner of Innovative Benefits Consulting. Diana M. Andersen SVP & Director of Corporate Benefits, Zions Bancorporation

Workshop Speakers: David Merritt Vice President and National Policy Director, Center for Health Transformation and the Gingrich Group Wayne Oliver Vice President, Center for Health Transformation

Niteesh K. Choudhry, MD, PhD, Harvard Medical School

Mike Seethaler Vice President of Business Development for TSYS Healthcare. industries.

Vincent Frakes Project Manager, Center for Health Transformation

Featured Speakers

Ron Bachman FSA, MAAA, Sr. Fellow Center for Health Transformation, President of Healthcare Visions & Chairman of CDHC Solutions Editorial Advisory Board

TRIBUTE

John J. Robbins Sr., Datapath

Loving Tribute to a Friend and Industry Leader Profoundly saddened by the untimely passing of DataPath founder and president John J. Robbins Sr., FieldMedia has chosen to honor a true innovator in the health care industry. Robbins, a larger-than-life individual, who in addition to being a successful businessman was a devoted husband, father and grandfather, succumbed to his bout with Hodgkin’s lymphoma on Feb. 22. He was 64. To help honor his memory, FieldMedia is proud to announce the creation of the John Robbins Sr. CEO Leadership Award as part of our annual Superstars issue, which honors creative innovators and problem-solvers in the health care and benefits industry. The recipient of the award will embody all the characteristics that Robbins displayed in his everyday life. An Army veteran, who was a visionary in the field of consumer-directed health care, Robbins used his ingenuity and caring personality to create DataPath, a software development firm specializing in creating administration systems for employee benefit reimbursement plans. “I was deeply saddened to learn of John’s passing,” FieldMedia publisher and CEO Doug Field said. “He was a good friend and one of the most respected leaders in our industry. He will really be missed.” Clients, family and friends have all been touched by the untimely passing of Robbins, whose life was a living testament for success professionally, personally and spiritually. “John was an incredible man,” said Linda Meyerhoffer, a client of DataPath. “Even though I only knew him through my business, he was a wonderful friend, great person and an outstanding father, who led by example. He is one reason we are in business today. His kindness and understanding helped us get started.” Many of those fortunate to have worked for or been in contact with Robbins, echo Meyerhoffer’s testimony. As one client said, spending time with Robbins made you a better person.

CDHC Innovations

SCIOinspire » willingboro Automated Pharmacy

SCIOinspire Launches Just InTime Wellness App on Benefitfocus Platform Benefitfocus and SCIOinspire announced the launch of the Just InTime Wellness App, which is now available through the BENEFITFOCUS® Platform. The App, developed by SCIOinspire, sends personalized, proactive alerts to plan members when preventive services are recommended or a “gap-in-care” is identified by analyzing individual plan member health care data. This innovative solution combines industry-leading health and benefits management technologies to help organizations reach wellness goals, increase member engagement, improve patient outcomes and decrease overall health costs. By turning on the Just InTime Wellness App, employers enable the health alerts, known as “My Wellness Alerts” and custom recommendations to be delivered to employees confidentially through the BENEFITFOCUS® HR InTouch portal. Upon logging in to the secure portal, members see My Wellness Alerts displayed prominently on the home page. By clicking on the alert logo, they are taken to a personalized and confidential portal. My Wellness Alerts are based on unique health data and focus only on the relevant issues pertaining to that individual. Employees are able to choose how they prefer to be notified when they have an alert: through text message, e-mail, telephone or mail. “The Just InTime Wellness App is helping our organization make the most of our care management and wellness initiatives and create an ongoing culture of health,” said Janis DiMonaco, president of HMC Companies. “It is a cost-effective way to provide members with the decision support tools and information they need, exactly when they need it.” The Just InTime Wellness App enhances member engagement and improves the effectiveness of the existing HR InTouch communication infrastructure. The App’s powerful predictive modeling algorithms proactively monitor member health and identify members for gaps 16

March/April 2011 I CDHC Solutions™ I www.cdhcsolutionsmag.com

A native of New Madrid, Mo., Robbins cultivated DataPath from a start-up business in the basement of his home in 1984 to one of the premier software solution providers in benefits administration. Diagnosed with Hodgkin’s lymphoma in late 2010, Robbins continued to work, alongside three of his six children John Robbins, Jr., Ben Robbins and Charles Robbins. All three remain with the company, and Robbins Jr., was named president of the company on March 10. “Since my father’s passing, I have been touched by the outpouring of love and support from our employees, clients and our peers in the industry,” Robbins Jr. said. “My father truly was an inspiration to all he met. I humbly accept my new position within DataPath. Not only did Robbins develop a successful business, he was an accomplished family man, who also was a pillar of the community in Little Rock, Ark. A man of devout faith, Robbins’ beliefs were a major influence in his life, and it showed in the relationships he developed. Married to his wife Kay Berry Robbins for 40 years, Robbins worked everyday with the single purpose to continually discover through grace his true self as he endeavored to know, love and serve God. This was the principle on which he based his relationships with his family and colleagues “John was successful as company president and as a family man,” Field said. “We believe naming this award after him is a fitting tribute.” PSuperstars nominations began April 1. Please see our ad on Page 34. If you would like to nominate someone for this award please visit www.cdhcsolutionsmag.com to nominate online or e-mail your Suparstars nomination to nominations@fieldmedia.com.

in care interventions, wellness and lifestyle-related communications. “Successful engagement requires accurate and timely identification of members,” said Dave Hom, President of Member Engagement and Care Management Services for SCIOinspire. “The delivery of wellness alerts through the HR InTouch portal allows employers across the country to enhance member engagement and take their wellness programs to the next level.”

Medco’s Willingboro Automated Pharmacy: 500 Million Prescriptions and Counting Less than 10 years after dispensing its first prescription, Medco Health Solutions, Inc.’s fully automated pharmacy in Willingboro, N.J., dispensed its 500 millionth prescription, securing its position as one of the world’s largest pharmacies based upon the number of prescriptions filled. “This milestone is significant because it demonstrates Medco’s vast capabilities in delivering smarter medicine safely, conveniently and efficiently to our members’ homes,” said Kenny Klepper, Medco president and chief operating officer. “The state-of-the-art technologies and clinical innovations we use at the Willingboro pharmacy, as well as our automated pharmacies in Las Vegas and Indiana, enable Medco pharmacists to focus on providing advanced pharmacy and clinical care, driving down health care costs and improving medication safety for Medco’s 65 million members.” Dispensing prescriptions to all 50 states, the Willingboro pharmacy also is home to the Medco Immunology and HIV Therapeutic Resource Center® (TRC). The Medco specialist pharmacists who work in this TRC provide patients who have complex medication regimens with highly personalized care designed to help improve and maintain health, enhance safety and help reduce costs. These specialist pharmacists are specifically trained in HIV and immunology, are aided by a fully wired and integrated data system, and are uniquely able to provide in-depth counseling to continued on page 18

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Briefs

People on the move

People on the move DataPath Names John Robbins, Jr. President, CEO

March 31, AmFed’s parent company Companion Property & Casualty Insurance Group announced. Mike Richardson, AmFed’s vice president and chief operations officer, will direct AmFed’s operations, Companion Property & Casualty said. Roberts founded AmFed Companies, LLC, in 1992. The company soon became the largest workers’ compensation managing general agency in Mississippi. In late 2001, AmFed National Insurance Co. was formed and began writing business on Jan. 1, 2002. AmFed National is currently the largest workers’ compensation writer in Mississippi. Companion Property and Casualty of Columbia, S.C., acquired AmFed in October 2008.

John Robbins Jr. has been named DataPath’s new president and chief executive officer after the death of founder John Robbins Sr. John Robbins Jr., who has served as DataPath’s vice president and director of health care payment solutions for the past four years, has been with the company since 1996 Robbins and is known in the employee benefits industry for his development of the myResourceCard® credit card in close partnership with national credit-card companies. The card has several patents on it and is a leading health care payment platform for many large companies across the country. “John’s death has profoundly saddened us all,” said Glen Hoffman, vice president and director of financial services for DataPath and a co-founder of the company. “He was a wonderful friend, and we will miss him greatly. We are comforted knowing his legacy and vision for the company will be carried on. John Jr. embraces the same passion and vision for this company. He is respected in our industry and recognized as an innovative leader in the consumer-driven marketplace. DataPath is in good hands, and I welcome John’s appointment to lead our company.” As one of the nation’s leading experts in the field of health care payments, John Robbins Jr. is a leader in new product development, serving as the lead for DataPath’s Consumer-Driven Healthcare Account Management Systems. He also was involved with the design of the HSAToday® program with regards to investments and bank card integration.

Bloom Health announced it has appointed Jodi Prohofsky, Ph.D., L.M.F.T., as its head of operations. Prohofsky joins the company from CIGNA, where she served as senior vice president of health management. While at CIGNA, Prohofsky was instrumental in developing the company’s nationally- Prohofsky recognized health advocacy approach that helps individuals maneuver the health care system by pairing them with a dedicated health advocate. She was accountable for an array of services and programming, including customer service, care and utilization management, mental health/substance abuse, EAP, a 24/7 nurse line, health coaching, and disease and lifestyle management. Prohofsky also is credited with being an early innovator in health and wellness, bringing to the market well before competitors evidence-based programs in consumer health, including tobacco cessation, stress management, and a program that uses behavior modification through coaching.

John W. “Billy” Roberts, president and CEO of AmFed National Insurance Co. of Ridgeland, Miss., has retired from the company, effective

Dr. Robert I. Lufrano, chairman and chief executive officer of Blue Cross and Blue Shield of Florida (BCBSF) has announced his intent to retire this

CDHC Innovations

Med-vantage » Blue Cross Blue SHIELD of Massachu

Continued from page 16

patients and address gaps in care that may be impacting their health. The Willingboro pharmacy can dispense more than one million prescriptions each week, and up to 99 percent of the orders processed are mailed out to patients within 48 hours after they are received at the pharmacy. Opened in August 2001, the Willingboro pharmacy—as well as Medco’s two other fully automated pharmacies in Las Vegas and Whitestown, Ind.—use a proprietary, sophisticated computer system called the Pharmacy Automated Controller (PAC) to control all activities at the pharmacies. The PAC customized server code contains more than 16,000 functions, more than 2,000 files and more than 1.7 million lines of code. The Willingboro pharmacy uses more than 2.6 miles of conveyor to expedite prescriptions through its automated system including labeling, filling and packaging functions. The tablet and capsule dispensing process can produce over 10,000 bottles per hour. The bottles and caps are specially designed for Medco automated pharmacies, and contain features that make them safe for children, but also easier for older persons to grip and open. The carton dispensing system is capable of labeling, consolidating and packaging more than 1,200 prescriptions per hour for more than 250 different medications. The pharmacy prints customized literature packages for each prescription with the ability to print more than 1,024 pages per minute.

Med-Vantage Launches Integrated Member Out-of-Pocket Cost Estimator Med-Vantage Inc—a health care software solutions company, offering innovative and distinctive solutions for consumer transparency, provider performance management, and personal health management—announced the release of its Member Out-of-Pocket-Cost Estimator.

March/April 2011 I CDHC Solutions™ I www.cdhcsolutionsmag.com

BlueCross BlueShield of South Carolina is the first customer to launch the solution, delivering it as a standalone tool as well as integrating the members’ costs into their Doctor and Hospital Finder, built on the Med-Vantage HealthSmart Enhanced Provider Directory, a webbased provider search tool. The Out-of-Pocket Estimator is a web-based Med-Vantage cost analytic module that helps members understand “what is this going to cost me?” The Out-of-Pocket Estimator calculates an estimate of a member’s out-of-pocket expenses for a given procedure by applying the applicable real-time benefits of the member’s specific plan to the calculated cost range. BlueCross is one of the first of the Blue Cross Blue Shield companies to run the Out of Pocket Estimator, based on the Blue Cross and Blue Shield Association’s National Cost Comparison Tool (NCCT) data, covering Association-defined treatment categories. This vital transparency information is fully integrated into BlueCross’ Doctor and Hospital Finder, which already provides their members with sophisticated hospital and doctor search capabilities as well as hospital quality data. Med-Vantage adds the Member Out-of-Pocket Estimator to its current list of clinical cost and quality analytics for a wide variety of transparency, member profiling, and provider performance measurement needs. Because most out-of-pocket calculators in existence today are designed for hospitals or providers at the point of service, they display cost information at the billing code level for a given provider—which members don’t understand. The Med-Vantage offering displays estimated costs for specific conditions, surgeries or procedures and is calculated based on a typical ‘service profile’ for the condition, surgery or procedure.

People on the move year. Dr. Lufrano has served as chairman and CEO since 2004 and has been with BCBSF since 1990. Dr. Lufrano’s retirement will become effective after the appointment of the new CEO and he will continue as board chairman through a transition period. The BCBSF board of directors has retained an executive search firm to assist with the CEO process to assess internal and external candidates. Dr. Lufrano is a member of the board of directors of America’s Health Insurance Plans, the Blue Cross and Blue Shield Association, The Florida Council of 100, the National Institute for Health Care Management, Prime Therapeutics LLC, and the board of trustees for the University of North Florida Foundation. In related BCBSF management news, Chris Doerr, executive vice president, chief administrative officer and chief financial officer, had previously (in 2010) informed the board of his intent to retire in 2011.

Assurant, Inc., a premier provider of specialty insurance and insurancerelated products and services, announced the appointment of Alan Colberg to the newly created position of executive vice president, marketing and business development, reporting to president and CEO Robert B. Pollock, effective March 28. In this new corporate post, Colberg will be responsible for fully integrating Assurant’s strategy with business-level innovation and growth plans. Colberg will spearhead the exchange of business development and operational expertise among the Assurant businesses. In addition, Colberg will lead Assurant’s marketing and the identification and development of new business platforms or capabilities consistent with company’s strategy. Scott & White Healthcare Board of Trustees Chairman Drayton McLane announced Alfred B. Knight, M.D. will finalize his transition from president and CEO of Scott & White Healthcare to his new full-time role as

usetts » MD-IT

briefs

president of the Scott & White Healthcare Foundation (Scott & White’s philanthropic arm), effective April 15. The Board appointed Dr. Knight to the Foundation leadership position in August 2010, in addition to his continued service as president and CEO of the merged hospital and clinic system and health plan, now known as Scott & White Healthcare. At that time, Dr. Knight stated his intent to work in tandem with his named successor, Chief Operating Officer Robert W. Pryor, M.D., MBA, to insure a smooth transition of leadership.

Tom Newton has joined Wellmark Blue Cross and Blue Shield as director of network engagement. Newton, former director of the Iowa Department of Public Health (IDPH), will be responsible for engaging Wellmark’s provider community—working with hospitals and physicians to better understand their business challenges, developing new programs, and building a strong foundation of quality health care in Iowa and South Dakota. Newton holds a bachelor’s degree in environmental planning and political science, and a master’s degree in public policy, both from the University of Northern Iowa. He also is a graduate of the State Health Leadership Institute, a program of Harvard University’s Kennedy School of Government. CareFusion Corporation, a global, medical technology company, announced the appointment of Kieran T. Gallahue as chairman and chief executive officer, succeeding David L. Schlotterbeck who previously announced plans to retire later this month. A seasoned medical-technology executive, Mr. Gallahue, was most recently president and CEO of ResMed, a global continued on page 44

» DrFirst

BCBS of Massachusetts Reveals Municipal Blue Innovation Award Recipients Blue Cross Blue Shield of Massachusetts (BCBSMA), a locally-based, community-focused health plan, announced the winners of the annual Municipal Blue Innovation Awards. Winners include the Town of Amesbury, Town of West Springfield, and Gateway Health Group (a group of seven municipalities/schools). In its third year, the Municipal Innovation Awards recognize cities and towns for achievements in improving employee health and wellness. John Coughlin, vice president of government and labor at BCBSMA, presented the awards to the winners in a ceremony at their local town halls. “Employee health care costs can be a city or town’s largest budget item, aside from salaries,” Coughlin said. “This year’s winners have taken important steps to educate and motivate their employees about wellness, which has proven to have a positive impact on the reduction of heath care costs.” According to the Centers for Disease Control, more than 75 percent of employers’ health care costs and productivity losses are related to employee lifestyle choices. A $1 investment in wellness programs saves $3 in health care costs, according to the Wellness Council of America. Amesbury, Wellness Education Champion, was the first Massachusetts municipality to join Well Power—a three-year program designed to help employees lead healthier lifestyles while learning to navigate the complex health care system. Initial results show that participants are actively engaged in educational seminars that teach participants to become savvier health care consumers, and personal health assessments that identify health risks and offer advice to address them. “ Wellness and education programs are ways we can better control the rising cost of health care,” said Amesbury Town Mayor Thatcher Kezer. “Well Power helps our employees and their families lead healthier lives—it’s good for our workers and good for the city.”

West Springfield, Innovative Health and Wellness Program Champion, successfully motivated employees to get fit through creative wellness programs. The town also promoted BCBSMA’s Blue Care Line, a 24-hour nurse care line members can call with medical questions. Speaking with a nurse before making a trip to the doctor or ER, is a convenient way to seek medical advice and save on health care costs such as copays and deductibles. The town saw a 117 percent increase in Blue Care Line utilization in the six months following the initiative, potentially preventing unnecessary trips to a physician or the ER.

MD-IT Partners with DrFirst for Innovative Prescribing Functionality to Physicians MD-IT announced a new partnership with DrFirst to provide comprehensive e-prescribing functionality to physician practices using the MD-IT Platform. The fully integrated e-prescribing solution will enable customers to improve prescribing safety and medical practice efficiency. With the integration of DrFirst’s Rcopia e-prescribing technology, MD-IT Platform users will now be able to easily and securely submit electronic prescriptions to any retail or mail-order pharmacy while accessing comprehensive clinical information for each patient. Accessible patient information includes drug and allergy interactions, complete prescribing histories and formulary information. Doctors and their staff members can easily access this SureScripts-RxHub Certified functionality from within the MD-IT Platform and all resulting prescribing data is instantly captured within the application. The joint e-prescribing solution will comply with the 2009 regulatory requirements issued by CMS. Additionally, customers using the solution will eliminate illegible prescriptions, issue faster prescriptions, and experience dramatic reductions in calls and faxes between the medical office and the pharmacy. www.cdhcsolutionsmag.com I CDHC Solutions™ I March/April 2011

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By E. Craig Keohan President » First Horizon Msaver

HSA / FSA / HRA

HSAs: An Unlikely Survivor of Health, Financial Reform

mericans love auto racing, especially NASCAR. The sport So how did this happen? has exploded in popularity in the past few years with no Didn’t the administration want to eliminate HSAs? end in sight. Perhaps, but groups like the American Bankers Association’s But what we seem to like even more than the race itself is the HSA Council were on a mission to keep that from happening. inevitable multi-car wrecks that accompany it – the uglier the better. Members of this organization did a lot of lobbying—in fact, they We cheer when there’s a good crash but then hold our breath hoping met with every senator and representative twice, educating them everyone’s all right. And we cheer even louder when a driver defies about the popularity and benefits of these consumer-directed the odds and is able to “drive through” a big pileup without so much spending accounts. as a scratch. The group has worked equally hard to make sure HSAs survive Health savings accounts (HSA), it turns out are a lot like that financial reform, especially the Durbin Amendment to the Doddracecar, emerging from an accident virtually unscathed. Frank Act, the financial reform legislation passed in July 2010. As we all know, the health insurance and banking industries The Durbin Amendment impacts interchange, the fee banks both took a beating in 2010. Since charge retailers to process credit card HSAs operate in both these sectors, transactions, usually a percentage of Members of this organization one would think they would have the total transaction amount. HSA [Amercian Bankers Association’s HSA vendors depend on interchange been seriously impacted by health care and financial reform, but that revenue for a significant portion of Council] did a lot of lobbying— really isn’t the case. If anything, HSAs their income, and it is largely because are in a better position now than they of interchange fees that the monthly in fact, they met with every were before “change” swept across the service charge on these accounts are senator and representative twice, nation. so low. There are two provisions of The Durbin Amendment reduces educating them about the the Affordable Care Act directly the amount that credit card companies impacting HSAs: As of Jan. 1, the can charge for interchange to just popularity and benefits of these penalty for using HSA funds for 12 cents per transaction, but thanks ineligible expenses jumped from 10 consumer-directed spending accounts. again to the work of the ABA’s HSA to 20 percent, and over-the-counter Council, it looks like HSAs might drugs are no longer an eligible expense unless you have a doctor’s dodge this bullet as well. prescription. Fortunately, neither of these are deal-killers for most The issue isn’t completely settled, but the Council has informed account holders—that’s the good news for HSAs. lawmakers that a reduction in interchange will adversely affect the The better news is HSAs aren’t going anywhere anytime soon. fees consumers pay for their health savings accounts, and they seem In the FAQ section of its website, the NAIC says, “nothing in to be listening. the legislation would infringe upon the ability of an individual to Nobody knows for sure what the long-term impact of health contribute to a health savings account…or discourage an individual care and financial reform will be, but for now it looks like we can from doing so.” The website continues, “The minimum level of cheer for the HSA – it’s successfully driven through the debris and coverage required to meet the individual mandate was specifically appears to be well on its way to victory. designed to allow for the purchase of a qualified high-deductible E. Craig Keohan is the President of First Horizon Msaver, Inc., one of the nation’s leading HSA adminisplan that would complement the HSA.” It looks like the bronze-level “minimum essential coverage” trators. He also serves as Chairman Emeritus of the American Bankers Association’s HSA Council. Craig can be reached at eckeohan@ftb.com. plan design will likely be HSA compatible. Since both employers and individuals are likely to flock to the least expensive plan that will allow them to avoid a penalty, HSAs are poised for substantial growth over the next several years as a result of health reform. Ironic, huh? www.cdhcsolutionsmag.com I CDHC Solutions™ I March/April 2011

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By Rob Thurston President, HR Consulting Group, Inc

Health Plans

Self-Funding, Pricing Transparency Popularity Rising Due to Health Care Reform

ealth care reform will cause many employers to lose their grandfathered status on their old medical plans. Under guidance released in June 2010, the federal government stated if an employer raises their deductibles, copays, or premiums over a certain percentage that the employee has to pay; the employer could lose grandfathered status. That means the employer is subject immediately to all the regulations of the Patient Protection and Affordable Care Act (PPACA). So what can an employer do about it? They can either look at pricing transparency or either partially or fully self-fund their medical plan. Do not expect your broker, insurance carrier, or consultant suggest these two options. Employers and employees need to lead the way; however, some employers and most employees feel differently. A survey by United Benefit Advisors (UBA) showed three clear and remarkable findings: n First, 22 percent of employers believe the primary responsibility for controlling health care costs reside with the parties directly involved: the employees, the physicians, and the hospitals. Almost all responsibility has been ceded to intermediaries: insurers/ health plans, government, and employers. n Second, an overwhelming majority of employers believe the federal government has a definite role to play regarding health care: that of requiring all hospitals, physicians, and insurers/ health plans to publicly disclose all cost and quality information. Employers desire access to the cost and quality information they and their employees need and deserve in order to make informed health care purchasing decisions in advance of receiving care. The employer and the employees have to be allowed to purchase health care the same way they purchase a home, a car, or any other goods or services. n Third, employers predict two significant changes to the health care system in the next five years: • All hospitals, physicians, and insurers will be required to publicly disclose all cost and quality information in advance of purchasing care or purchasing insurance. • Employers will increasingly adopt a “total compensation” approach whereby employees will receive a single compensation amount over which they will have total control to allocate their money toward take-home pay, health benefits, retirement or savings plans, or non-health benefits in the manner they feel appropriate to their needs.

The results of the survey indicate nearly all are determined to change the way they and employees purchase health care. Employees want and deserve control over how their money is allocated and which providers they use for care. Many employers will then look at partial or full self-funding and adding a health reimbursement arrangement (HRA under Section 105) to help them control costs. Partial self funding means to implement a high-deductible health plan and the employer uses an HRA to self fund the difference between the old lower deductible and the new high deductible. Full self-funding means the employer assumes 100 percent of the risk but may use specific, aggregate, or even the new spaggregate stop loss insurance policies. It is obvious the employee/consumer is slowly becoming better educated and interested in controlling his/her own health care. For instance, Blue Cross Blue Shield stated 60 percent of Americans have looked up information to make a better-informed medical treatment decision. Ninety-four percent of those who have not searched said they would if they or a family member needed medical care. Eighty percent said they still talk to their primary medical provider, and an additional 70 percent said they use the Internet as their basic research tool. Zogby International surveyed 1,209 people and posed the question: “Do you agree or disagree that hospitals, doctors, and pharmacies should publish their prices for all goods and services?” Eighty-four percent agreed, with only 14 percent disagreeing. The survey also asked: “If you knew the prices a hospital, doctor, or pharmacy charges, how likely would you be to shop around for the best price?” According to the results, 79 percent said they would be likely to shop for the best price (51 percent “very likely” and 28 percent “somewhat likely”). Today Americans are used to seeing and comparing prices. The question is why would health care be an exception to the rule? The answer is it probably wouldn’t be. People want to know how much it costs if they are paying for it. The transition to a consumer-driven health care society is imminent. The consumers know it. Do the health care providers know it too? Rob J. Thurston, President of the HR Consulting Group (www.hrconsultinggroup.com), has been a national speaker and noted author on HR consulting and systems development since 1981. He has implemented and designed some of the largest selling employee benefits software systems nationwide while part of an international brokerage firm, a national administration firm and while as a consultant. Currently, he is the best selling author of the Health Care Reform Kit on CD and of the Self-Funding Kit on CD. He also is aworking on the development of a large database of providers and vendors for Self-Funding and new Benefits services. If you would like a complimentary copy, please call at (801) 765 4417 or email Hrconsultinggroup@msn.com www.cdhcsolutionsmag.com I CDHC Solutions™ I March/April 2011

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is your Culture of Wellness Really Working?

growing number of employers talk about building a “culture of wellness,” and that is, indeed, a wonderful idea. But few employers actually seem to be achieving that goal. According to analysis by Towers Watson, 34 percent of employees said the programs offered by their employer actually encourage them to live a healthier lifestyle. One in five said they were using wellness programs designed to help them lose weight or stop smoking. With all the tools for employee engagement at our disposal, its frustrating so many employees remain disengaged with wellness opportunities. Many wellness programs may be unwittingly excluding 20, 30 or even 40 percent of their population because of unanticipated issues like uncertainty of the economy, stress at work, time constraints, language barriers, transportation issues, or a general mistrust of the health care system. It has become increasingly clear that to be effective, a true culture of health must work to anticipate the barriers preventing employees from participating. In the past, wellness programs were not sophisticated enough to detect such barriers, but today, there are breakthrough technology platforms to engage more employees. New technology solutions allow businesses to mine and merge thousands of bits of individual data about each employee. These “data profiles” help reveal current and potential member health issues and can help detect individual barriers to health engagement. By utilizing this information, highly personal and individualized messaging can be created, engaging, educating, directing, and motivating members to take timely health actions. In addition to achieving better member wellness outcomes, new engagement technologies offer a turnkey solution requiring no new investments in IT, marketing or staffing because it integrates easily with existing disease management plans. These technologies can go live quickly, without service interruptions and sees an average increase of 19 percent in member engagement.

The Key tools of Engagement to Help you Achieve a Culture of Wellness The best new intelligent messaging technologies utilize six key tools to engage employees. 1. Highly Personalized Messaging The more specifically your communications relate directly to the recipient, the greater your odds of motivating them to take action. New engagement technologies allow plan sponsors to create communications that include a personalized greeting and directives the member can easily follow to meet a preventive care need, incorporating “the five Ws: what, when, where, who, and why” of understanding.

2. Educational Messaging Education can be a mighty tool in improving wellness compliance. In a recent study by the Midwest Business Group, 88 percent of workers surveyed said they “lack an understanding of the value of preventive services.” They did not know why they should get an annual physical, colonoscopy, pap smear or other preventive measure. Today’s wellness messaging tools clearly communicate the health risks and potential adverse outcomes specific to each member. 3. Decision Support Tools Behavioral science shows it is easier to persuade individuals to respond in a certain manner when you get them to interact with you. That’s why successful direct mail and e-mail campaigns crossing all categories utilize surveys, check boxes, stickers and other interactive tools to engage recipients. 4. Ongoing Response Tracking and Message Refinement Thanks to new technology, wellness programs can now track member responses to communications and then automatically refine and execute new messaging based on member responses to previous messaging. 5. Capacity for Problem Solving In the old days, who knew that health plan members skipped their colonoscopies or mammograms because they had no transportation, or were frightened to take it? Today, intelligent messaging technologies allow wellness plans to predict potential logistical, financial, educational or emotional barriers and provide messaging or solutions, helping members navigate around these challenges. 6. Outcomes Measurement Understanding your outcomes is the key to achieving greater success in wellness engagement. New technology platforms provide timely reporting that allows companies to adjust their programs, coverage and messaging to achieve better returns on investment. If your culture of wellness has not been embraced to the degree you had hoped for or has not achieved the kind of return on investment you had imagined, you may not be getting the right messaging to the right people at the right time. New intelligent messaging technologies will enable you to do that, helping you to create a true culture of wellness in which everyone has an opportunity to participate. Peter Saravis is co-founder and CEO of Evive Health, a leading innovator in designing personalized communication tools that motivate individuals to engage in health and wellness enhancement activities that improve their health, lower health care costs and lead to a happier and healthier lifestyle. Contact Peter at peter@evivehealth.com or visit evivehealth.com. To view this article in its entirety, Please see www.cdhcsolutionsmag.com. www.cdhcsolutionsmag.com I CDHC Solutions™ I March/April 2011

Can you see what you could be throwing away?

Use the Healthy Sight Calculator. If your workers aren’t taking advantage of a premium vision benefit, you could be paying a hefty price in avoidable healthcare costs and productivity loss. Find out for yourself. Take the “See the Savings Challenge” and calculate the cost avoidance possible for your workforce. Just for using the Healthy Sight Calculator at www.HealthySightWorkingForYou.org, you’ll be entered into a drawing to win one of two $500 prizes.

By Thomas R. Giddens Senior Vice President, Co-Director of Sales » Aflac

Supplemental Benefits

Supplemental Insurance Policies Can Help Increase Consumer-Driven Health Plan Participation

et’s agree the future looks very bright for consumer-driven health plans. After all, the growth figures say it loud and clear. As of January 2010, approximately 10 million people were covered by health savings accounts (HSA) and/or high-deductible health plan (HDHP) products—a number that has steadily increased by more than 9 million over the last five years. And, health care reform may continue to fuel growth in this sector for many years to come. Yet, there is a proverbial elephant in the room. Several factors are threatening to deter the growth of HSAs/HDHPs, stemming from both employers and the workers employed by them. The perception (or perhaps reality) is HSAs/HDHPs are best suited for the young, healthy and wealthy who don’t incur a large amount of health care-related expenses, or who can afford a high deductible and have funds for a rainy day. In the worksite market, HSAs are not always applicable or suitable, like in blue-collar or even gray-collar segments. Employers have a difficult time introducing HSAs/HDHPs to workers who likely are unaware of such plans or simply don’t understand the benefits. All of these factors lead to reluctance when it comes to enrolling in these plans. There is a solution that can remove these barriers. Having supplemental insurance policies, alongside an HSA/HDHP, can not only help bridge the gap in out-of-pocket expenses, but it may help ease workers’ anxieties about enrolling in these programs.

Effectively Addressing Out-of-Pocket Costs Associated With HDHPs The average annual deductible with HSA/HDHP policies for a family is $4,418, and the average out-of-pocket limit is $5,064. HSAs are only as successful as the participant’s willingness and commitment to contribute adequately to the fund. Many families are left with financially devastating out-of-pocket costs in the event of a serious illness or accident. In fact, medical expenses caused 62 percent of all bankruptcies. This number was up nearly 14 percent over a similar study conducted just four years earlier. More surprising is 75 percent of those declaring medical bankruptcy reported having health insurance. Supplemental insurance policies include long-term, critical illness or events, such as cancer, accident and disability coverage, and pay cash benefits to help cover deductibles and other out-of-pocket medical expenses. For example, with a critical illness policy and/or accident policy, a lump sum benefit is paid upon diagnosis of cancer, heart attack, stroke, etc. This provides policyholders the cash needed to help pay for expenses, treatments and daily living costs before the HDHP benefits begin.

Accident coverage also provides first dollar benefits to policyholders for medical expenses relating to accidents. The reality is many consumers question their ability to financially prepare for, or withstand, a serious illness or accident with HSA/HDHP coverage alone. Couple this concern with the possibility that employees do not understand or are not comfortable with how HDHPs, HSAs and HRAs work, and the likelihood is that fewer employees may be willing to opt for this type of coverage.

Enhancing Enrollment Through Education and Peace of Mind Business owners wanting to implement a high-deductible health plan should consider initially offering supplement plans alongside to help those in need of funds to deal with a sudden high deductible claim. This will not only ease potential anxieties or fears of employees, but it will give the company time to educate their employees about how HSAs require them to budget and save for unforeseen health expenses. Ongoing, concise and clear communication is the foundation to benefits education, and ultimately helps workers make more informed decisions about their health care coverage. A 2009 Aflac/RTi Market Rearch Survey “Why Supplemental?”, found that nearly half (49 percent) of employers strongly agree their employees need to be better engaged about their benefits. Engagement in a benefits program is difficult to attain without a basic understanding of the options available, their pros and cons, and whether or not they are a good fit. Given the fact supplemental insurance policies have no direct cost to employers, this is a win-win solution. Companies can continue to better manage their insurance costs, and employees have access to well-rounded insurance coverage and the opportunity to effectively manage their own health care expenses. Without clear and steady education about HSAs/HDHPs and offering options that limit employees’ gaps in coverage while helping to safeguard their finances, employers may be challenged by a workforce more reluctant than enthusiastic about enrollment. S Thomas R. Giddens joined Aflac in 1983 as assistant vice president in the marketing department before serving in the field for more than 20 years. In 2007, Mr. Giddens’ numerous achievements and contributions were recognized when he became the youngest member of the Aflac Sales Hall of Fame. During his tenure with Aflac, Mr. Giddens was assistant vice president in the marketing department; regional sales coordinator and state sales coordinator of Georgia-North; and Southeast Territory director. Most recently he was appointed as co-director of sales. For more information on Aflac, call 1-800-99AFLAC or visit www.aflacforbusiness.com. www.cdhcsolutionsmag.com I CDHC Solutions™ I March/April 2011

Wellness

Embracing Long-term Strategy by Reducing Cost, Promoting Cultural Change

agemann Stamping Company is a fullservice stamping company recognized worldwide as a leading manufacturer of deep drawn metal stampings. From innovative product development to creative tool design and unique manufacturing solutions, Jagemann Stamping Company has proven time and again their integrated approach to manufacturing works. Since its inception in 1946, Jagemann

has understood the health and wellness of its employees brings value to the company’s bottom line, the strength of their teamoriented culture, and ultimately the quality of the products delivered to its customers around the world. The founder, William P. Jagemann, Sr., son, William T. Jagemann, Jr., and grandson, Thomas M. Jagemann, have continued to build a legacy of taking a holistic approach to their business.

What began with providing first dollar coverage for key preventive care back in the 1990s, has evolved into a comprehensive health and wellness program supported by leadership and embraced by the employees. In 2004 Jagemann began to investigate consumer-driven heath care options in response to the rising cost of health insurance. Management’s goals were to reduce employee health risks, control

Integrated HSAs and Wellness Programs Case Study Consistent Long Term Results Today, Jagemann Stamping Company incentivizes their employees who participate in the Trotter Wellness program by contributing $1,100 into each employee’s family HSA account and $550 into each single HSA on an annual basis. As a result, 81 percent of Jagemann Stamping Company employees are participating in the wellness program offered by Trotter Wellness, and 67 percent are taking advantage of the health savings accounts offered through HSA Bank. The Jagemann family believes every dollar they invest in their health and wellness programs, the company will get multiple dollars back. This belief is validated in the return on investment analysis Trotter Wellness provides to Jagemann management on an annual basis.

March/April 2011 I CDHC Solutions™ I www.cdhcsolutionsmag.com

“Not only are we achieving our goals and helping our employees live healthier, more productive lives, “ said Thomas M. Jagemann, president and CEO, “but we’re meeting those goals without significantly increasing the employees’ health care costs. “The Mission of Jagemann Stamping Company’s Wellness Committee is to improve the mental and physical well-being of JSC employees and dependents by increasing awareness of and supporting behavior toward

healthier lifestyles, resulting in a focused, voluntary utilization of the Healthcare System. With the support of its Trotter Wellness program, Jagemann Stamping Company continues to offer its employees multiple opportunities to participate in wellness activities, set personal goals and to achieve personal behavior change. The program includes n Onsite fitness facility n Onsite educational presentations in their education center, including a

YEAR

Total Program Cost Per Year*

Estimated Claim Savings Per Year

Return on Investment

2005

$29,925

$493,553

16.49

2006

$28,535

$434,726

15.24

2007

$27,090

$423,646

15.64

2008

$27,480

$549,698

20.00

2009

$27,480

$537,198

19.55

By Patrick Trotter, president, CEO, Trotter Wellness

costs, and continue to develop a culture of positive change the Jagemann family had been developing over the past 60 plus years. However, the company needed help in identifying the appropriate next steps and quantifying the cost savings and value to its employees. In May 2004, Jagemann was introduced to Health Solutions Ltd., now Trotter Wellness®—a nationally recognized leader in comprehensive wellness programming. With the help and consultation of Trotter Wellness, Jagemann decided to implement a new set of strategic wellness program offerings including: n Lifestyle health risk awareness tools— to understand what preventive and corrective services would most benefit employees and their spouses n Logistics planning, and customized wellness program design—to maximize employee participation and target the company’s top health risks n Optimal Health Coaching™—to provide employees and their spouses Healthy at Heart series provided by Trotter Wellness. The goal of these sessions, as outlined by Jagemann to employees, was to help employees become a wise health care consumer and make better decisions about their health and health care consumption, putting them in the driver’s seat. n Annual kick-off event/health fair celebrating safety accomplishments, provided biometric screenings, massages n Successful weight-loss challenge n Inclusion of wellness items in a monthly newsletter

with a personal, professional resource to help reduce risks or stay well n Comprehensive results reports and return on investment reporting In April 2005, Jagemann Stamping Company offered a health savings account (HSA) plan in addition to the traditional preferred provider organization (PPO) plan. Jagemann selected HSA Bank as its HSA administrator. HSA Bank has focused exclusively on health-based savings accounts since 1997. Utilizing HSA Bank’s experience and expertise, they designed an HSA program for Jagemann to offer employees incentives and a benefits option with greater savings potential by: n Passing along premium savings on the HSA plans to employees n Making contributions to employee HSAs with amounts determined by wellness incentive program progress n Educating employees about the tax benefits and savings potential of an HSA

The collective impact of the changes made was felt immediately. Almost 60 percent of the employees signed up for health savings accounts in the first year, and Jagemann management saw the average medical claims per year decrease by more than 40 percent. Health savings accounts through HSA Bank helped the employees understand they could manage and save their health care dollars, which drove interest in Optimal Health Coaching and the health and wellness tools offered by Trotter Wellness. Employees of Jagemann Stamping Company wanted to understand how being healthier and making educated decisions could help them save their own money, which in turn contributed to Jagemann’s bottom line.

present status of lifestyle behaviors and make suggestions for the future.

health risk assessment. Optimal Health Coaching provides: n Review of health risk assessment results n Discussion of top risk factors n Assessment of readiness to change n Goal setting n Educational resources

Annually, all Jagemann Stamping employees, who want to earn the contribution to their HSAs, must complete the Trotter Wellness health risk assessment, participate in the biometric screening and complete at least two telephonic health coaching sessions with a professional health coach from Trotter Wellness.

The health risk assessment accomplishes the following: n Identifies current health risks n Offers suggestions for ways to improve the employee or spouses’ lifestyle n Points out the benefits of good health habits n Informs participants of where they are doing well n Indicates improvements over time n Gives participants the information needed to take charge of their health n Assesses 14 risk behaviors, chronic conditions, diseases, symptoms and medications along with all major health conditions n Emphasizes modifiable health risks n Provides personalized stage of readiness to change for each health risk

The health risk assessment is designed to improve quality of life by evaluating the

Optimal Health Coaching targets 100 percent of those who complete the

The Integration of Wellness and Health Savings Accounts Trotter Wellness and HSA Bank have developed a long-term partnership to provide wellness services to account holders.

The ultimate goal of the Jagemann Stamping Company’s health management program is to produce a measurable return on investment. The progress and success made over the course of the last six years is demonstrated in the measurable health risk improvements, as well as health care cost savings. The continuation of the program and other services provided through Trotter Wellness and HSA Bank places Jagemann Stamping Company in a strong position to provide employees and spouses with opportunities for further health improvements, positive lifestyle change and ultimately real cost savings.

www.cdhcsolutionsmag.com I CDHC Solutions™ I March/April 2011

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Wellness

HSAs are tax favored savings vehicles that roll over year-to-year, allowing account holders to build funds to pay for medical expenses now and into the future. Participants utilizing this partnership take advantage of Trotter Wellness’ proven system of identifying an individual’s highest health risks through the health risk assessment, educating themselves with Trotter Wellness’ wellness related web resources and health information portal, and taking action and setting goals to reduce those health risks in fun and effective ways with personalized health coaching. HSAs are tax favored savings vehicles that roll over year-to-year, allowing account holders to build funds to pay for medical expenses now and into the future. Participants utilizing this partnership are becoming healthier and savvier when it comes to health care spending; resulting in account holders spending less of their HSA savings on unnecessary health care services and keeping more of their savings for use on necessary and appropriate services. The integration of a health and wellness program from Trotter Wellness assists HSA account holders with living healthier lifestyles, which often reduces the need to seek medical care, insuring they are in better control of their overall health, health care consumption habits, and health care spending. Numerous reports state a $1 investment in wellness programs provides employer returns ranging from $3 to $5. Wellness programs through Trotter Wellness provide employees with the key tools for reducing health risks through healthier lifestyles, which means more of their HSA funds are saved. Specializing in a full range of wellness programs since 2002, Trotter Wellness provides comprehensive return on investment wellness programming for employers of all sizes

nationwide, including program management, health risk assessments (HRAs), web tools, biometrics, telephonic health coaching and outcome, and ROI reporting. “Trotter Wellness is dedicated to providing employers and their employees, nationwide, with the wellness program elements to support behavior change; the resulting reduction in health care costs and increase in productivity is imperative to the success of companies today” noted Trotter Wellness president Patrick Trotter. Employer Benefits: n Reduces medical claims n Increases employee productivity n Reduces employee sick time n Reduces short-term disability costs and workers’ compensation costs n NCQA certified health risk assessments n HIPAA compliant n Returns an average of $5.20 for every $1 invested HSA Bank has exclusively handled the health savings account needs of employers and their employees since 1997. HSA Bank continuously strives to provide superior service, unparalleled expertise and innovative technology. HSA Bank administers more than 330,000 accounts nationwide to more than 21,000 businesses. “Health savings accounts naturally fit with wellness plans because prevention and better disease management lowers health care costs for employers and employees alike,” said Kirk Hoewisch, president of HSA Bank. “By offering an integrated wellness solution, we have added great value for our employers and accountholders.” Employer Benefits:

HSA-compatible health plans typically have lower premiums than traditional plans n Lowers employer’s FICA, unemployment and workers’ compensation taxes. n Offers a variety of options for enrollment, contributions and employee education n Provides reliable and responsive support to its business partners and account holders from friendly, knowledgeable service staff. n

Patrick received a BA in Interpersonal Communications and Business from Marquette University and earned a Master’s Degree in Public Health Administration and Prevention from Loma Lind University in California. Patrick brings with him 30 years of senior leadership experience in the full continuum of American health care system including hospitals, clinics, long term care, home care, insurance, occupation health, wellness and EAP. He is a fellow in the American College of Health Care Executives and has served as an adjunct professor for the Universities of Wisconsin and Minnesota. Patrick has also provided leadership US Bank, Orion Energy Services, Nemschoff, the VAAST Corporation, the National Guard, Boy Scouts of America, Institute of Family Medicine, Juvenile Diabetes Association and the Visiting Nurses Association. Kirk joined State Bank of Howards Grove as the vice president of operations in 1995. In 1997, he led the initiative to offer medical savings accounts (the predecessor to health savings accounts) on a national scale. Over the last 13 years, Kirk has led this business unit, now marketed as HSA Bank, to create a product that combines low fees, competitive rates, and dedicated service. HSA Bank leads the competition, which is just now entering the HSA market. Now, with more than 25 years of banking experience, and as the president of HSA Bank, Kirk is dedicated to the strategic development and management of the HSA Bank team.

www.cdhcsolutionsmag.com I CDHC Solutions™ I March/April 2011

Brand drug costs keep rising, but

My total drug costs rose less than 1%

We have the prescription for lower overall costs The proof is a Prime number Prescription drug costs are rising 1 — especially brand-name drugs. Yet despite the trends, Prime Therapeutics has been able to keep our clients’ overall costs consistently low. We focus on more than just brand discounts. Combined with our generic rate, smarter formulary management and benefit design, we keep costs down. The proof? Our drug trend result is below 1%.2 We can help you manage your costs too.

Learn more by visiting YourPrimeNumbers.com/ outcomes or call 800.545.9042

Duff, W. “Drug makers raising prices before reform.” NYTimes.com. 15 November 2009. Accessed 20 May 2010. http://www.nytimes.com/2009/11/16/business/16drugprices.html.

Prime Therapeutics, Book of Business Data, 2009.

consUMer-DirecteD HealtH care

Consumer-directed Health Care movement

Continuing to Gain Momentum

here is little doubt consumer-directed health care (CDHC) is definitely gaining momentum. The number of health savings accounts (HSA) and health reimbursement arrangements (HRA) grew by 375 percent over the last five years. What makes CDHCs so attractive for lowering the cost of health care are four factors: reduced insurance premiums, increased consumer responsibility, the effect of market competition in the provider market, and automation that makes the plans costeffective and easier to administer. The employee—or more accurately, the consumer; after all, health insurance is a form of compensation—pays less for a higher-deductible, lower premium plan. By using high-deductible plans, premiums can be substantially lower. If an employee has low health care expenses, the difference in savings is immediately realized by both the employer and the employee. By coupling a high-deductible health plan with a health reimbursement account such as an HSA, HRA, FSA or other consumercontrolled account, employees have several incentives to make not only healthy lifestyle choices, but also better consumer choices. Healthy consumers spend less on health care. Smart consumers shop with care to get a better price on treatment and prescriptions, ultimately spending less. “CDHC plans can be even more effective when they work in conjunction with wellness incentives,” said Ernie Harris, senior CDHC product manager for Ceridian Corporation, a partner of Lighthouse1. “The money you save on health care costs can be used to fund incentive rewards, which is a valuable way to continue to invest in your employees’ well-being.” As the trend of employers pushing responsibility for health care to employees continues with CDHC solutions, consumers are more engaged and motivated to shop for and manage

their individual spending. In turn, this has forced price transparency and fueled demand and innovation for lower cost, consumercentric delivery options. Simply put, healthy competition reduces price. Significant advancements in the technology and processing of CDHC plans include administration platforms, consumer websites and support tools, mobile applications, and payment solutions such as health care debit cards. These tools not only simplify and streamline the overhead and cost associated with servicing CDHC plans, but they add to the engagement of consumers.

HealthSCoPE Beneﬁts Across the United States large companies, as well as public sector organizations (state governments themselves, school districts, municipalities, and so on) are implementing CDHC plans. Lighthouse1 partner HealthSCOPE Benefits is a full-service claims administration and health management firm headquartered in Little Rock, Ark. While the rate at which states and large companies are embracing CDHC for their employees has had a slow start, Joe Edwards, CEO of HealthSCOPE, believes a trend is developing. “Several years ago, I kept hearing and reading that within five years, 50 percent of staterun entities would have a highdeductible plan,” Edwards said. “While it got off to

By JeFF Bakke CHIEF STRATEGY OFFICER liGHtHoUse1

a slow start, things have really picked up in the last year or so, and we’re hitting that 50 percent threshold.” So why was the start so slow? Controlling health care costs is a complex task and involves many moving parts: employees, their wellness or risk factors, and how they utilize the health care system. Other factors include the employer’s provider network and the design of the benefit plan. “Most companies try to solve the problem by attacking one or two of these pressure points,” Edwards said. “At HealthSCOPE

www.cdhcsolutionsmag.com I CDHC Solutions™ I March/April 2011

NOMINATE & RECOGNIZE INNOVATIVE HEALTH & BENEFITS MANAGERS

Do you know someone who goes the extra mile? A health and benefit manager who is a creative problem solver and innovator We’re looking for the industry’s true superstar—professionals in health care and benefit management, including: solutions providers, brokers, TPAs, employers, benefits coordinators, and HR managers, who have excelled at implementing solutions to complex health care benefits issues. Superstars to be published December 2011 and will be accessible to more than 70,000 readers.

Nominate ■

■

today!

John J. Robbins Sr., Memorial CEO Leadership Award: To an outstanding leader of any size organization who is an exceptional businessperson, as well as a successful parent and pillar of the community. CEO Leadership Award: To an outstanding leader of any size organization, who embraces supports and endorsed an innovative health care or benefits program. Most Innovative Plan Design Award: To an HR/Benefits executive who identified and solved a problem using an innovative health care or benefits program. Most Effective Plan Implementation Award: To an HR/Benefits team that successfully implemented a health care or benefits program and exceeded goals or reaped unanticipated awards. Most Innovative Employee Education/Communication Award: To an employer, who designed and implemented tools for their employees that exceeded plan participation. 500 - 2500 employees

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■ ■ ■

■

Most Innovative Employee Empowerment Award: To an employer, who designed and implemented tools that had a high engagement of employee participation in a health care or benefits program. Most Effective Population Health & Wellness Award: To an employer who uses the most innovative method to reduce absenteeism and chronic disease costs to improve overall employee health. Public Policy Leadership Award: An individual who encourages health care consumerism in public policy through legislation. Most Effective Solution Provider Award: To a solution provider who introduces the most innovative health care or benefit solution. Most Innovative Partner-Consultant Award; To a consultant who worked most effectively with an HR/Benefits team to implement a health care or benefits program. Most Innovative Broker Award: To a broker, who learned a client’s needs and provided the most effective solution for the employer.

Nomination Categories: 2501 - 7500 employees

7500+ employees

For details, please visit www.cdhcsolutionsmag.com or www.employersweb.com. Nominations close Sept. 30, 2011. E-mail your Superstar nomination to nominations@fieldmedia.com or nominate online.

consUMer-DirecteD HealtH care

Benefits, we take a different approach. We unite all of these elements to work toward one desired objective: ‘Total Health Management’.” The result, Edwards added, is delivering annual health care cost trends in the low single digits versus the double-digit averages that prevail in the health care industry.

Ceridian Corporation At Ceridian Corporation, a leading provider of health insurance exchange services, benefits administration, corporate wellness programs, and outsourced payroll and human resource services, businesses are quickly beginning to understand the benefits of CDHC, according to Harris. In fact, for the 2011 plan year, two-thirds of all Ceridian’s large employer benefits sales were enabling CDHC plans. Clients often combine several plans for maximum savings. Harris said employers offer CDHC plans to give employees real incentives to use medical services wisely. Many employers choose to integrate wellness incentives with CDHC contributions to further promote prevention and responsible health care spending. “The underlying assumption of a consumer-directed health plan is employees will make more informed choices and avoid unnecessary or excess medical care if they have to use more of their own money to pay for it,” Harris said. While all CDHC plans may provide a benefit to both the employer and the employee, HRAs, HSAs, and FSAs have distinct advantages. For example, an HSA allows employees to take greater responsibility for their own health care and to save money—both for today, as they cope with rising costs, and for the future, as they face retirement. An HRA, the plan most employers choose because it gives employees time to adapt to the CDHC model, gives the employer more control over employee spending. It allows the employer to determine plan rules. An FSA can save employers approximately 8 percent on payroll taxes as their employees enjoy up to 40 percent in tax savings on medical and dependent care expenses. When combining these CDHC savings with the long-term, cost-containment provided by wellness programs, employers are well-positioned to combat rising health

Clients often combine several plans for maximum savings. care costs. “We fully expect our clients’ interest in CDHC plans to continue to increase in the future,” said Harris, who predicts a bright future for account-based health plans.

Powered by Lighthouse1 With more than 2.5 million consumers—including HealthSCOPE Benefits and Ceridian Corporation customers—using Lighthouse1 OnDemand™ to manage their HSAs, HRAs, FSAs, and Transit Plans, Lighthouse1 is the nation’s largest cloud computing health care solution. More than 100 of the nation’s largest health plan providers, third party administrators, and financial institutions use the innovative, web-based Lighthouse1 platform to administer their consumer-driven health care accounts. Lighthouse1 OnDemand is the only solution available today that meets more than 1,100 unique benefit plan designs, simplifies the user experience, and satisfies workflow management needs of administration partners, employers, and consumers. Last year, Lighthouse1 added more than 170 enhancements to Lighthouse1 OnDemand. This year, the company plans to include nearly 200 additional enhancements, empowering, extending, and innovating the Lighthouse1 solution. Because of the solution’s innovative architecture, new enhancements can be released throughout the plan year with no interruption to user experience or service levels. Recognizing that mobile devices represent the next stage in consumer selfservice, the company’s mobile solution, Lighthouse1 Mobile, continues to evolve with advanced features and functionality. The solution enables consumers to access and upload information about their health care account, 24/7/365 from anywhere, via their smartphone. Dozens of time-saving administrative features in Lighthouse1 OnDemand 2011 help partners, like HealthSCOPE Benefits and Ceridian Corporation, expand their HSA, HRA, FSA, and wellness businesses while increasing operational eﬃciencies as well as

the satisfaction of employers and consumers. Additionally, My Personal Health Suite and Learn CDHC—the first of many valueadded Solutions from Lighthouse1—are designed to help employers and consumers make better, more informed health care decisions, while managing costs and improving wellness. Lighthouse1 continues to build key relationships by signing multi-year partnerships with two of the nation’s largest banks, as well as a number of large health plans and leading third party administrators to provide additional features and functionality to their respective existing CDHC offerings. These partnerships solidify Lighthouse1’s leadership in the consumer-driven health care industry and reflect the company’s growth in the areas of HSA and HRA. Last year, Lighthouse1 facilitated more than $2.4 billion in reimbursement transactions and processed more than 24 million claims across all consumer-directed account types, all with an uptime of 99.999 percent. “In the midst of extraordinary change in the health care industry, one thing remains constant: Our dedication to reducing costs and simplifying the business of health care,” said Jeff Young, CEO of Lighthouse1. “Consumers want more control over health care spending for themselves and their families. Because of our robust business model and our strong network of partners, we are poised to make an unprecedented difference in the management of all types of CDHC reimbursement funds, ultimately helping consumers maximize their health care dollars.” Jeff Bakke is incredibly passionate about creating business results through the use of technology. As chief strategy oﬃcer at Lighthouse1, he leads the charge in setting the strategic direction for the company’s products and services. As a recognized technology leader in the consumer-driven health care market (CDHC), Lighthouse1—a worldclass customer service organization— is dedicated to reducing costs and simplifying the business of health care. Jeff’s commitment and vision for delivering on Lighthouse1’s mission is evident through the company’s innovative technology solutions, highly successful partnerships and services relationships, and improved operations and infrastructure processes. Jeff’s career in business and technology management with health care and financial services companies spans more than 20 years and includes working with Blue Cross and Blue Shield of Minnesota, Medica Health Plans, Allianz, and American Express.

www.cdhcsolutionsmag.com I CDHC Solutions™ I March/April 2011

tools anD tecHnoloGy

Point, Click, Cured a

Online Care Brings Health Care Directly to Employees at Work or Home

By roy scHoenBerG, MD, MPH, fter years of discussion and debate, are connected immediately, without having health care reform has begun to schedule an appointment or leave work or aMerican Well systeMs to unfold in the United States. home. Although reform’s arrival brings with it many During an Online Care visit, employees now are offered through leading health plans, unanswered questions, it is clear the central actually see and talk to a health care provider delivery networks, retail pharmacy chains and role of employers in managing employee making the conversation feel very personal employers from coast to coast. health will not change. (see Figure 2). The provider is able to If anything, it will grow in importance. review the patient’s clinical information, Impact For Employers Employers cite several motivations for This reality leaves employers with a tall order discuss symptoms, diagnose, and prescribe to fill: offer innovative health care services that medications as appropriate, for anything offering employees Online Care services: n Productivity. With Online Care, help attract and retain employees, while also from common illnesses such as colds, flu, and employees gain an alternative to taking increasing productivity and controlling rising sinus infections to chronic care management, time off from work or waiting to be seen medical costs. behavioral health or nutrition. At the end of for a doctor’s appointment. Instead, they At the same time, employee expectations the consultation, the employee is encouraged can address health concerns as soon as are rising. They are demanding convenient to share a full record of the conversation with they arise. It allows employees to stay medical services that can fit into their busy his or her primary care physician, maintaining focused and less preoccupied at work or schedules. After all, other tasks that touch continuity of care. home. them daily—banking, shopping, and booking Online Care debuted in January of n Medical cost. Employers see Online Care travel—are readily available whenever needed, 2009, when Blue Cross Blue Shield of Hawaii as an option that helps employees avoid online, from their homes or desks. made the service available to every resident unnecessary, expensive visits to the ER, A study from Euro RSCG showed 78 in the state—members, non-members, and urgent care centers or provider oﬃces percent of Americans would like to visit with the uninsured. During the past two years, and address their issues in the lower-cost doctors online, too. Instead, all too often, Online Care services have grown rapidly and employees take time off of work to travel to, and wait for doctor appointments, or Figure 1: Online Care enables immediate access to providers simply lose productivity while worrying about their unaddressed health issues.

Introducing online Care To address these challenges, one solution increasingly adopted by employers is Online Care—a service offering employees the ability to come together with health care providers online for immediate, live conversations using video, secure text chat or phone. With Online Care, participating providers make themselves available for online and phone consultations at any time, for as long as they choose and from any location. Employees can log on whenever they have a health need, from their workplace or home (see Figure 1). They simply search for the provider who meets their needs (such as a female, Spanish-speaking PCP) and 36

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settings of the home or workplace. Employee satisfaction. Providing a differentiating service encouraging employees to manage their own health and the health of their families, in a convenient and affordable way, reflects the commitment of an employer to its staff’s well-being.

A growing amount of market experience illustrates how these goals are playing out for employers around the country. Three leading health care companies—Blue Cross and Blue Shield of Minnesota, OptumHealth, and Blue Cross Blue Shield of Western New York— who are working together with employers, provide a particularly valuable view of Online Care in action.

Blue Cross and Blue Shield of minnesota In late 2009, Blue Cross and Blue Shield of Minnesota (Blue Cross) became the first health plan in the continental U.S. to offer Online Care services. “We saw the potential for Online Care AnywhereTM to improve the health and well-being of consumers across Minnesota, but felt it had a particularly compelling value for our employer partners,” said Sig Muller, VP business development for Blue Cross. “Employers were looking for a way to improve employee access to care and provide convenient options beyond the time and

expense associated with traditional doctor visits.” As a result, Blue Cross began its path toward a statewide consumer rollout by making Online Care Anywhere available to its own employees and their family members, from their homes or workplaces. To facilitate access, Blue Cross also devised a further innovation—the “Virtual Employee Clinic”—a private, secure room in the oﬃce where employees can go to use Online Care Anywhere services. Blue Cross set up four Virtual Employee Clinics on its campus, each equipped with a computer, webcam, phone, and printer, as well as a biometric machine to record data such as weight, body mass index (BMI) and blood pressure. The feedback from Blue Cross employees has been very positive. Ninety percent of employees reported they were very satisfied or satisfied with the Online Care Anywhere service. One employee shared, “My wife used the service twice and so did a few of my direct reports. All provided very positive feedback on the experience. This says a lot about the company and ‘walking the talk’ if you ask me.” Another employee said, “I just had my first call to a physician for my eye infection problem. The doctor was outstanding and it was quick and very eﬃcient. I will use this great service again—what a time saver.” By mid-2010, due to strong employer

Figure 2: A live Online Care conversation

demand, Online Care Anywhere was extended to additional employers, including global medical technology leader Medtronic and food manufacturer Schwan’s. Both companies began offering Online Care Anywhere to all employees and their families. Similar to Blue Cross, Medtronic has set up three Virtual Employee Clinics around its facilities, and Schwan’s has created four. Based on the enthusiastic response, Blue Cross decided to expand availability of Online Care Anywhere to all residents of Minnesota. What results have Minnesota employers seen? Blue Cross continuously conducts surveys among Online Care Anywhere users to understand their care experiences. They found the service is indeed impacting productivity. In terms of time-savings, 73 percent of users saved an hour or more by using Online Care Anywhere instead of going to see a provider elsewhere—with many of those hours reflecting paid work time. In addition, 85 percent of employees completely resolved their health issues with Online Care Anywhere, eliminating the need for in-person visits and ensuring they could quickly return to work and family life. Finally, employees shared they used Online Care Anywhere instead of more expensive settings, including provider oﬃces, retail clinics, and urgent care.

optumHealth OptumHealth, a business of UnitedHealth Group, was the first company to create an Online Care service that is national in scope: NowClinicSM online care. “We are committed to offering all consumers access to convenient, affordable health care services,” said Rob Webb, CEO of OptumHealth. “However, NowClinic sees particularly strong demand from employers around the country who are looking to offer employees an innovative new service that also improves their family and work lives.” With that in mind, OptumHealth joined forces early on with one of its most prominent employer partners: Delta Air Lines. Through OptumHealth’s NowClinic Online Care service, all Delta’s Minnesota-based employees and family members have real-time access to a network of physicians, around the clock. www.cdhcsolutionsmag.com I CDHC Solutions™ I March/April 2011

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Figure 3: Physician-Based “Reverse Practice”

As NowClinic expands across new states, its “anytime, anywhere” ethos matches well with Delta’s busy, highly mobile workforce. Following the Delta launch, OptumHealth announced the expansion of NowClinic to all consumers across all of Minnesota. Several additional employers, yet to be announced, also have begun working with OptumHealth to offer NowClinic to employees in multiple states. By choosing to leverage Online Care, OptumHealth is able to increase access to care for employees when they need it most—whether it occurs during work hours, in the middle of the night or on weekends.

Blue Cross Blue Shield of Western new York Blue Cross Blue Shield of Western New York (BCBSWNY) became the first company to offer Online Care on the East Coast with the introduction of its Online Care NYSM service. Although it has made this service broadly available to members throughout its home region of Buffalo, BCBSWNY has engaged local employers and made a special effort to drive awareness among its own employees. This included an innovative way of introducing the service: commissioning a local theatre troupe to bring the Online Care concept to life through a series of performances for employees. A cast of professional actors, writers and directors created “Mouse Calls,” an interactive workshop illustrating the benefits of Online Care, when employees should use it, and the experience of interacting online with a local physician—all using reallife vignettes. Ten theatrical presentations took place over the course of four days at BCBSWNY’s headquarters.

Figure 4: Health & Wellness-Based “Reverse Practice”

[reverse practice has] a significant potential to reduce the “trial and error” approach many employers reluctantly go through as they pay for health interventions for their employees. “We felt it was appropriate to think outof-the-box when bringing such an innovative new service to our employees,” said Cindy Eberl, director of physician outreach at BCBSWNY. In addition to Mouse Calls, BSBCWNY created a suite of four, state-of-the-art Virtual Employee Clinics at its headquarters, designed to provide employees with a private setting to consult with providers and keep Online Care top-of-mind. BCBSWNY also has begun working closely with its employer partners, who also have conducted events to inform employees about Online Care and opened Virtual Employee Clinics, on-site.

A-la-Carte Employer Practices As employers increasingly adopt Online Care, efforts are under way to further enhance the service’s value to employees and their families. One new development is the “Reverse Practice”—the ability for employers to assemble a dynamic, constantly changing spectrum of health care professionals that accurately caters to the profile of employees and their needs (see Figures 3 and 4). Such practices that can morph based on employee

traﬃc, is one of the unique advantages of Online Care. These have a significant potential to reduce the “trial and error” approach many employers reluctantly go through as they pay for health interventions for their employees. They involve: n New provider types – Employers are realizing Online Care services provide an opportunity to make a broad range of experts and specialists available online, from sleep specialists to fitness experts and pharmacists. These new provider types ensure employees turn to Online Care not only when they are sick, but when they want to improve their overall health and well-being. n Flexible and tailored services – Employers also are looking to offer Online Care services reflecting the needs of various segments of their workforces and that can be adapted over time. For example, a retailer with young associates may value having a nutritionist and fitness coach available for consultations about healthy living, while an older, chronic population may benefit from a team of primary care providers, cardiologists, and nutritionists to help manage hypertension and high cholesterol.

As the health care system experiences great change, employers are taking extra strides to offer services that help entice and retain employees, all while managing productivity and rising health care costs. The experiences of employers across the country are illustrating the potential of Online Care to deliver on these needs. Roy Schoenberg, MD, MPH is CEO of American Well Systems. www.cdhcsolutionsmag.com I CDHC Solutions™ I March/April 2011

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By Josh Hilgers » President, Founder Health Partners America and Health Partners Training

Ask Your Broker

Why Ask Your Broker for a Defined Contribution Plan?

rivate sector employers, especially small business owners, are the backbone of our economy and our country. Unfortunately they are being overly burdened by increasing operating expenses, specifically their health insurance premiums. For the last 40 years, the common expectation was the employer would pay for health insurance. This was never the best way for people to get health insurance but a way around the wage and price controls at the end of World War II. So what would a better system look like? In a nutshell, it would consist of (1) completely portable policies owned and designed by the employee; (2) tax free, fixed dollar, contributions from the employer and employee; and (3) choice for each employee of which carrier and which plan design provides the best protection for their family. Fortunately for employers and employees there is a platform existing today that accomplishes these features. It is called a defined contribution health plan (DCHP). Like defined contribution retirement plans (401k) replaced Defined Benefit (pension plans) before them, DCHPs are revolutionizing employee benefits. Defined contribution plans offer several benefits for employers: • Attract and Retain Good Employees – The purpose of an employer’s benefit plan is to attract and retain good employees. Unfortunately the current group benefits model makes accomplishing this and remaining profitable a difficult task. The defined contribution approach gives employees more choice, better coverage, and more affordable options, stretching the dollar for both the employer and the employees. • Cost Control and Predictability – One of the greatest benefits of the defined contribution approach is employers can define the allowance that is affordable to them, and the employees can choose from a multitude of plans that offer them the best balance of coverage and premiums. Also, the carriers aren’t dictating participation and funding requirements or throwing in rate increases that can throw a company’s budget out of balance. • FICA Savings – For employers who do not offer benefits to their employees, they are missing out on some huge tax advantages. For every dollar an employee sets aside for his or her premiums or for spending accounts such as health savings accounts (HSA) or a flexible spending account (FSA), the employer saves 7.65 cents or 7.65 percent – the matching FICA contribution. With the average family spending around $10,000 on premiums and HSA/FSA contributions, this would equal close to $800 a year per employee. A company with 20 employee families would look to save more than $15,000 just by offering a section 125 plan. • Greater Appreciation from Employees – Unfortunately most of the time, effort, and money spent by employers to offer benefits to their employees go unappreciated. The high premiums of group insurance plans typically require a significant share of that cost to be contributed by the

This new platform will be a big part of the employer-sponsored insurance market in the next few years, and is a proposed solution for the future solvency of Medicare and Medicaid. The smart brokers are learning about this platform and developing tools to give themselves an edge over their competition. employee. While this can be payroll deducted on a pretax basis, the amount required to contribute is still more than most employees can afford. The thousands of dollars employers are willing to contribute are left on the table because the employee cannot afford his or her share. To the employees in this situation, the employer might as well not offer benefits at all. The defined contribution platform is the best solution for most businesses today. As more options become available for those with preexisting conditions and more mandates and higher costs are placed on employers with the implementation of the PPACA over the next few years, many more businesses will be looking for this solution. The platform consists of a few basic points. • The employer setting up a cafeteria plan and/or HRA to reimburse premiums • The employer deciding on whether or not they want to make a contribution and what amount • Employees meeting with brokers to decide the best options in major medical, supplemental, and spending accounts for their family • Enrolling their premiums in the cafeteria plan • Reimbursements for individual plans made to employees This new platform will be a big part of the employer-sponsored insurance market in the next few years, and is a proposed solution for the future solvency of Medicare and Medicaid. The smart brokers are learning about this platform and developing tools to give themselves an edge over their competition. Health Partners Training has developed a well-rounded training video on the concept and a toolbox with all of the field-tested tools an agent would need to get started. For more information visit us at www.trainhp.com or email josh@ healthpartnersamerica.com.

www.cdhcsolutionsmag.com I CDHC Solutions™ I March/April 2011

Statistics & Data

CDHPs

By Chris Riedl, Head of Enterprise Medical Products, Aetna

CDHPs: A Timely Solution

he challenging economic times have made it imperative for companies to be creative and relentless in containing costs. As the cost of health care continues to skyrocket, it is important for employers to consider options like consumer-directed health plans (CDHP)—health plans with a proven track record of supporting wellness, while controlling costs. These plans provide an opportune, cost-effective solution for companies. Data showed replacing traditional health benefits plans with Aetna HealthFund CDHPs and successfully engaging employees in their own care allows employers to both help employees stay healthy and keep health care costs in check.

A Proven Solution for Employers

The economy is uncertain, leading both governments and corporations to look for ways to contain costs. One of the first places many are looking is health benefits. It’s little wonder, as the overall cost of health care has continued to rise, while the health and wellness of our

Companies do not have to take extreme measures to help bring down health care costs. They just need to look at applying the American way—consumerism—to health care through the use of consumer-directed health plans. nation has declined. According to the U.S. Centers for Disease Control and Prevention, nearly one in two adults lives with a chronic illness. The end result is an increase in health care costs as the CDC estimates more than 75 percent of health care costs can be attributed to chronic illness. The good news is chronic diseases are controllable and even preventable. So, we should focus our efforts on improving the nation’s health, which will ultimately lead to a decrease in the overall cost of health care. During this time of uncertainty, HR managers are making difficult choices regarding the benefits offered to employees. But companies do not have to take extreme measures to help bring down health care costs. They just need to look at applying the American way—consumerism—to health care through the use of consumer-directed health plans. CDHPs not only provide a proven costbenefit to employers, but also create a more educated, aware and health-conscious consumer base. At Aetna, we have been able to demonstrate that CDHPs can save companies millions of dollars a year while turning plan participants into informed health care consumers who take

January/February 2011 I CDHC Solutions™ I www.cdhcsolutionsmag.com

an active role in their health and wellness and get the quality care they need. Despite their advantages, many companies are not offering CDHPs to employees because they simply do not understand the benefits. That’s a big loss at a time when companies can ill afford one.

“But What are CDHPs and How do They Work?”

CDHPs are health benefits plans centered on the engagement of consumers in health care decision-making. There are three main components: a health reimbursement account (HRA) or health savings account (HSA), high-deductible medical coverage that typically includes 100 percent coverage for preventive care, and access to educational tools and information. The plans are set up to encourage members to understand and have greater involvement in their own health care decisions. The employee can appropriately choose how and when his or her health care dollars are used. Pre-tax money is set-aside in a savings account by the employer, the employee or a combination of the two. This money can be used to pay for medical expenses before the member uses his or her own post-tax income. This helps take the sting out of the high-deductible plan. For example, if a member has a high-deductible plan with a $2,500 deductible, he or she can first tap into a health reimbursement fund or an HSA to help pay for care. Because the plans have higher deductibles, which translates to more up-front costs for plan participants, employees are more likely to be motivated to become informed health care consumers, deciding what care they need and where to get that care to maximize every dollar they spend. However, for this system to work effectively, the insurer must promote healthy decisions and behaviors through educational tools and informational resources for its members and incentives. According to a recent study of Aetna’s own consumer-directed products, members utilize online tools and access information at twice the rate of those in other plans. The study showed employees are becoming more educated about overall health care costs, creating a more knowledgeable, cost-aware consumer base in an economic climate that can only benefit from the widespread application of such knowledge.

CDHPs

Why CDHPs?

Nothing spells out the value of CDHPs better than the numbers. For full replacement plans, our recent study showed employers saved $21.5 million for every 10,000 members over the five-year period. For companies providing employees with the option of a CDHP they saved $9 million for every 10,000 members over five years. From a health perspective, employees in CDHPs spend more on preventive care and visit the emergency room less. Female patients access more women’s health screenings, and members with diabetes screen at higher rates as well. We also have learned patients still use necessary prescriptions to treat chronic conditions, like their counterparts in PPO plans. Significantly, there is greater selection of generic drugs, increasing overall health care savings. This study successfully challenges the argument that CDHPs are cost-effective only because members end up not getting the care they need. In reality, members continue to access appropriate care, especially preventive and chronic.

Strategies for Companies

Companies can implement a number of strategies to maximize the value of CDHPs, including: • Working with the insurer to design a plan that includes appropriate levels of member responsibility; • Encouraging employees to enroll in the consumer-directed plan option by lowering the employees’ premium contribution levels or increasing the amount of the employer contribution to the fund or account; • Communicating and educating members on how to use the plans and supporting tools; and • Offering wellness programs and incentives for healthy behaviors. For example, many employers require employees to fill out a health assessment to better understand the health needs of the workforce. The results help employers customize a health and wellness program for employees. By enacting the above strategies, your company can simultaneously maximize cost savings and improve employee wellness.

Statistics & Data

Many employers require employees to fill out a health assessment to better understand the health needs of the workforce. The results help employers customize a health and wellness program for employees. Choosing Health

In this age of consumerism, people want choice and autonomy over important aspects of their lives – including their health. Ideally, CDHP participants will gain knowledge about healthy behaviors and access preventive and chronic care, as necessary. Ultimately, CDHPs can benefit those who are healthy and those with chronic conditions. As the full replacement data from the survey confirms, savings are evident across all populations (see comparison of Full replacement AHF HRA/HSA and Option AHF HRA/HSA medical costs charts). As an added benefit, they provide governments, companies and consumers with a timely opportunity to cut down on overall health care costs while promoting and encouraging a healthy nation. Please visit CDHC Solutions Online (www.cdhcsolutionsmag.com) for specific survey results and the Aetna HealthFund Study press release. Additionally, we encourage you to visit our website, www.aetna.com, for more health plan information. You also may contact at us any time with questions—we are always available to help you find or design the plan that best fits your company’s needs (630-810-9052). Chris Riedl is a senior manager responsible for the strategy and product management for medical products at Aetna, including consumer-directed health plans, online consumer transparency tools and incentive program offerings. Ms. Riedl joined Aetna’s Annuity Division in 1987, where she held a variety of increasingly senior roles in product development and management, system migration and annuity contract administration. In 1996, Chris joined Aetna’s Healthcare Division, where she was a major contributor in the strategy, development and implementation of the HMO suite of products in the Midwest and was responsible for several new products nationally for the Middle Market segment. Additionally, she has supported a number of key business initiatives, including the U.S. Healthcare, NYLCare and Prudential integrations. She most recently served as the head of product development for Middle Market. Ms. Riedl graduated summa cum laude from the Loyola University of Chicago with a Bachelor of Science in Criminal Justice. She holds a Health Insurance Associate and Managed Healthcare Professional designation and is licensed with the State of Illinois as a Life, Accident & Health Insurance Producer.

www.cdhcsolutionsmag.com I CDHC Solutions™ I January/February 2011

Briefs

People on the move

Continued from page 19

leader in medical equipment for treating, diagnosing and managing sleeprelated respiratory disorders. During his tenure, the company grew revenue approximately 500 percent to $1.2 billion, while expanding operating margins and increasing net income more than 20 percent annually.

AssureRx Health, Inc. announced the appointments of two senior executives in key roles to drive company growth. Donald R. Wright, Jr. has been appointed as executive vice president and chief operating officer and John A. Bellano as senior vice president, sales and commercial programs. Wright has been instrumental in leading the development of AssureRx’s pharmacogenetic test, GeneSightRx, and the blueprint of products the company expects to develop over the next two to three years. In his new position, Wright will play a fundamental role in leading AssureRx’s future product offerings, operations, and external relationships and he will continue managing software product development, overseeing information technology and molecular genetics laboratory operations, as well as customer support, field sales support, quality assurance, and human resources. Bellano is joining AssureRx as a key member of the executive team, leading the company’s sales efforts to increase adoption of GeneSightRx, launching new products in development, and leading the company’s efforts with Diamond Healthcare and other strategic partners. Streamline Health Solutions, Inc., a leading provider of document workflow solutions for hospitals, announced Robert Watson has been appointed president and chief executive officer effective February 1. Watson has been involved in the health care information technology industry for more than 25 years with extensive experience in all operational facets of the industry from senior management to sales and marketing. J. Brian Patsy, founder of Streamline Health Solutions, and current president and CEO since its inception, has retired at the request of the board of directors from both positions and also has resigned as a director of the company. Previously, Watson was president and CEO of DocuSys, Inc., a leading provider of anesthesia information systems that was acquired by Merge Healthcare Incorporated in March 2010. The TharpeRobbins Company, Inc. has named Ed Robbins to the newly created position of senior vice president of sales and strategy. Robbins reports to Brett Tharpe, president and chief executive officer. Robbins most recently served as vice president of O.C. Tanner, where he created a new division focused on incentives and marketing services. Previously, he served as vice president of performance solutions for Corporate Express and was general manager of the Incentive and Recognition Division of the Target Corporation. Robbins also led his own strategic planning firm, serving the recognition, incentive and marketing services markets. Evolution Benefits (EB), the industry leader in electronic benefit payment services and software, announced the appointment of former P+W Software executive, Fred “Bud” Bockoven, CFCI, as a vice president of sales. With more than 30 years of industry experience, Bockoven will focus on strengthening and expanding the growth of Evolution Benefits’ PayDirect benefit administration software in the national consumer-directed marketplace. Since 1998, Bockoven has overseen sales, marketing, and client relationships for P+W Software, one of the most well-established and successful software firms in the benefits business and a long-time partner of Evolution Benefits.

March/April 2011 I CDHC Solutions™ I www.cdhcsolutionsmag.com

Bloom Health announced it has appointed John Vlajkovic and Manny Menendez to key leadership positions on the Bloom Health sales team, adding a depth of industry expertise that puts Bloom at the forefront of the defined contribution health benefit space. Vlajkovic joins the company from Aon Hewitt, where he advised corporate officers on the development of innovative benefit designs, Menendez most recently was the Chicago Health Management Market Manager at Aon Hewitt, where he advised national employers on health care plan selection, budget rate development, and measurement. Vlajkovic and Menendez will report to Kevin Kickhaefer, who recently joined Bloom as head of sales and market development. Comprehensive Care Corporation announced it has further strengthened its management team through the appointment of several highly experienced health care professionals over the past several months. The new members of the CompCare team have assumed new and existing roles at the company in order to help advance its business through continued innovation of services and to implement an expanded sales and marketing plan. The most recent was the appointment of Dr. Susan Norris, former CEO of MHNet Behavioral Health, to serve as CompCare’s senior vice president of operations, effective March 1. Nancy J. Blaski, has been named vice president of managed care at Trustmark Companies. The announcement was made by David M. McDonough, chief executive officer of the Lake Forest, Ill.-based insurer, benefits administrator and health management services provider. Blaski joined Trustmark in 1992 as Cost Containment Coordinator and has served in several positions of increasing responsibility in the firm’s Managed Care department, most recently as second vice president. She has earned the professional designations of Health Insurance Associate, Associate in Customer Service, and Managed Healthcare Professional, and had been a member of several customer advisory boards representing both Trustmark and CoreSource. CIGNA announced it has promoted Christopher De Rosa to regional vice president for the company’s west region. De Rosa, who most recently served as the general manager for CIGNA in southern California and Nevada, brings more than 20 years of health care industry expertise to the position. CIGNA’s west region comprises California, Oregon, Washington, Nevada, Arizona, Colorado, Utah, Wyoming, New Mexico, Idaho and Montana. An internal and external search is under way for a new general manager for southern California and Nevada. De Rosa, who joined CIGNA in 1992, has held various positions with the company in small group, national accounts and regional segment as well leading sales effectiveness and customer reporting. Christopher C. Booth of Pittsford, N.Y., has been appointed president of Excellus BlueCross BlueShield. The announcement of his appointment came from David Klein, the company’s chief executive officer, and Randall Clark, chairman of the board of directors for health plan’s holding corporation, The Lifetime Healthcare Companies. Joining the company in 2004 as chief administrative officer and general counsel, Booth was promoted to executive vice-president for Commercial Markets and Health Care Affairs in January 2009. He has more than two decades of experience working with the corporation.

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The Health Reform Navigator organizes massive information into a simple searchable format. It provides easy access to actual legislative language, regulations from DOL, HHS, and the Treasury, multiple industry and think tank time lines, and industry surveys on what employers think of reform. You can stay alert to HOT TOPICs, read independent legal and consulting observations, and much more. There are even more than 50 government produced videos and multiple private conference video links. “The Health Reform Navigator is a great new tool for our readers to get answers to questions that make their jobs easier”

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A combined $400 value, subscribers can get instant access and a one-year subscription for $99 or $9.99 for a monthly subscription. CDHC Solutions also is offering a one-year subscription for free by signing up for pre-conference event sponsored by Center for Health Transformation. For details please see www.cdhcsolutionsforum.com.

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AmeriFlex

TSYS Healthcare®, provides end-toTSYS Healthcare end strategic payment solutions for 612.338.3871 consumer directed healthcare. We www.tsys.com/solutions/healthcare partner with benefits administrators, healthcare@tsys.com financial institutions and health plans and software providers to navigate all aspects of HSAs, HRAs, FSAs, cash reimbursements and lines of credit. TSYS Healthcare cards offer participants the security they expect along with the ability to conveniently access funds from multiple accounts and manage their benefits payments with simplified single-card access. Clients and partners benefit from simplified processes, reduced paperwork and cost savings that contribute to improved return on investment.

“We built the TSYS Healthcare platform to meet the market demand for reliable, configurable and intelligent solutions. Understanding the dynamic U.S. Healthcare market, our customers rely on our option-driven system to prepare them for the future. “ — Trey Jinks, Group Executive, TSYS Healthcare HSA/HRA/FSA Technology: Administration & Management

DataPath, Inc., is one of nation’s largest providers of CDH solutions specializing in account-based administration systems.

DataPath, Inc.

1601 WestPark Drive, Suite 9 Little Rock, AR 72204 501.296.9990 www.dpath.com

Since 1984, service providers using DataPath systems have provided administrative solutions for over 1 million participants of FSA, HRA, HSA, and COBRA. DataPath is the only solutions provider to design and deliver a full Suite of systems for handling 125, 105, 132, COBRA, HSAs, Credit and Debit Cards all delivered to account holders through a single Internet portal, myRSC.com.

“With the significant changes in healthcare today, our software solutions allow users to create custom plans for clients that benefit both the employer and employee. Not only have we created a single platform for all systems with myRSC.com, with the integration of our mySourceCard Debit Card at Wal-Mart and other retailers, our clients are able to offer a hassle-free solution with 100% compliance.” ®

302 Fellowship Road, Suite 100 Mount Laurel, NJ 08054 Internal Sales Support: 888.868.3539 (FLEX), option 4 Proposals and Marketing Inquiries: info@flex125.com www.flex125.com   Established in 1998, AmeriFlex is an independent benefits administrator providing technology-based, consumer-driven benefits and compliance solutions. n AmeriFlex

Convenience Card® Consolidated FSA/HRA/HSA/CRA Debit Card Platform n AmeriFlex Convenience Sleeve Consolidated FSA/HRA/HSA Healthcare Payment Solution n AmeriFlex Convenience Portal WebBased System for Streamlined Administration of CDHC Plans

n Mongoose®

Enterprise Class, Web-Based Solution for COBRA Administration n ePOP Instant POP Plan Online Document Ordering n Invoice Manager Paperless, Automated System for Group Claim Activity and Funding Administration

“At AmeriFlex, we are constantly looking for new ways to bring innovative and cost-effective payment solutions to the market in order to improve efficiency and simplify the delivery of healthcare products and services to all stakeholders.” — William Short, President & CEO, AmeriFlex HSA/HRA/FSA Technology: Administration & Management

No other solution available today has been so Lighthouse 1 deliberately designed to meet the benefit plan design, user experience and unique workflow 9800 Bren Road East, Suite 250 management needs of administrators, employers, Minneapolis, MN 55343 and consumers. As a web-based, real-time www.lighthouse1.com platform, Lighthouse1 OnDemand™ saves 952-908-9056 employers and consumers more than $1.2 billion a year in tax savings and administrative costs. Lighthouse1 OnDemand is the engine that combines technology, healthcare and banking to provide automation in the healthcare industry. Lighthouse1 and its partners serve more than 2.5 million consumers, making Lighthouse1 the nation’s largest web-based healthcare solution that manages HSAs, HRAs, FSAs, and Transit Plans.

“Rising healthcare costs, increased employer expectations and a challenging economy create tremendous opportunities in the CDH industry. Lighthouse1 is uniquely positioned to combine superior services and innovative technologies to administrators, employers and consumers. With the recent launch of Lighthouse1 Mobile, consumers now have even more access to their healthcare benefits and more control over their healthcare spending. Together with our strong network of partners, we are poised to keep reducing costs and simplifying the business of healthcare.” — Jeff Young, Chief Executive Officer for Lighthouse1 www.cdhcsolutionsmag.com I CDHC Solutions™ I March/April 2011

Who’s Who Profiles

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Solutions to help your innovative health and benefit programs. Tools and Technology

As the premier provider of proven CDH technology solutions for benefits administrators, we know that your needs are many and varied.

T o ta l P o pu l at i o n H e a l th Car e Ma n a g e m e n t

314.439.5300

www.bemassoftware.com PayDirect CDH gives you all the functionality sales@bemassoftware.com that you need to administer your consumer driven healthcare benefits programs with ease and efficiency. PayDirect CDH... Is fully integrated with the industry’s leading benefits card that achieves the highest auto-substantiation rates n Administers complex HRAs with multiple tiered payouts and a variety of deductible arrangements n Handles specialized financial management and billing requirements n Provides access to an extensive range of reports with advanced functionality n

Automates repetitive processes. Imports and exports data to eliminate manual entry and allow integration with other business systems n Fulfills critical compliance requirements such as discrimination testing and CMS reporting n Includes an easy-to-use, customizable online portal n

Call today! Don’t wait to increase your efficiency.

P r e s c r i pt i o n B e n e f i ts Ma n a g e m e n t

We’re facing a healthcare crisis in our country. The cost of providing benefits—including prescription benefits—has become extremely painful for employers. The problem is that until now, solutions haven’t come to market that really address the root problems of the issue—cost and use. However, thanks to Align, Restat’s new pharmacy benefit model, self-funded employers will have a PBM whose interests are aligned with theirs. This partnership will enable employers to save millions of dollars in prescription drug costs annually. To learn more about Align and to read what internationally recognized consulting firm Milliman has to say about our process visit www.align.restat.com. David Kwasny, R.Ph., President

March/April 2011 I CDHC Solutions™ I www.cdhcsolutionsmag.com

www.CDHCSolutionsmag.com

Who’s Who Profiles

Access these profiles online at www.CDHCSolutionsMag.com and www.EmployersWeb.com tools and Technology

Liazon was founded in 2007 to tackle the myriad problems inherent in employee benefits for small and mid-sized employers. Liazon’s retail employee benefits solutions give employers a cost-saving defined contribution strategy for all benefits. Liazon’s Benefits Exchange™ is the online store where employees find, learn about and purchase health care and other insurance products.

Liazon 737 Main Street, Suite 200 Buffalo, NY 716.803.6190 708 Third Avenue New York, NY 212.209.3836 www.liazon.com

“Liazon’s Bright Choices Benefits Exchange is the online store where employees shop for their benefits. It brings an exciting new retail model to employee benefits that empowers benefits consumers and saves employers money. Think of it as the ‘amazon.com’ for employee benefits.” — Ashok Subramanian, Co-founder and CEO, Liazon P R O F E S S ION A L

The AHIP Center for Insurance Education and Professional Development has offered educational programs for more than 50 years to professionals like you.

DE V ELO P MEN T

AHIP Center for Insurance Education and professional development 601 Pennsylvania Ave., NW South Building, Suite 500 Washington, D.C. 20004 800.509.4422 www.AHIPInsuranceEducation.org

With more content online, including overall health insurance, reform implementation, LTC, DI, and more, the Center will help you learn, achieve, and succeed.

D e c i s i o n S upp o rt & C o st - S av i n g s T o o l s

My HSA Rewards allows individuals My Hsa Rewards to earn cash rewards for purchases 12460 Crabapple Road made through merchants Suite 202-254 participating in the program. Alpharetta, GA 30009 At launch, the merchant network consists of hundreds of major online 404.551.5543 retailers representing thousands of www.myhsarewards.com brands. The program works like an sanders@myhsarewards.com airline mileage program, but, instead of earning miles, participants earn cash rewards that are directed to a health savings account (HSA). There is no cost to the employer or the employee to join.

“If you want to grow your Health Savings Account faster and with ease, My HSA Rewards is a smart and simple way to put real cash into your HSA from the purchases you make every day.” — Sanders McConnell, President, My HSA Rewards P har m a c e ut i c a l B e n e f i ts Ma n a g e m e n t

Envision Pharmeceutical Envision Pharmaceutical Services, Inc is a full service pharmacy benefits Services, Inc. management company that delivers! John Ewell, EVP Marketing We deliver because our business 925.487.3266 model is based on transparency www.envisionrx.com and full disclosure, guaranteeing jewell@envisionrx.com 100% pass through pricing of all pharmaceutical manufacturer rebates and administrative fees at the point-of-sale. Additionally, our affiliate, Envision Insurance Company, is a national Prescription Drug Plan which enables us to offer a variety of solutions for your retirees. Envision is truly a “different” PBM! “Envision is pleased to be recognized by its clients surveyed by the Pharmacy Benefits Management Institute for three consecutive years as the top performer in virtually every category evaluated. This solidifies our leadership position in providing transparency and full disclosure to the PBM marketplace while continuing to find innovative solutions.” — Kevin M. Nagle, President & CEO, Envision Pharmaceutical Services/Rx Options

www.cdhcsolutionsmag.com I CDHC Solutions™ I March/April 2011

Who’s Who Profiles

www.cdhcsolutionsmag.com

Solutions to help your innovative health and benefit programs. Effective print and online opportunity to put your company, its solutions, and your chief sales executive in front of 60,000 print and online prospects. How do you make your company and its solutions accessible to more than 60,000 health care benefits decision-makers, generate leads, and do so cost effectively? By participating in the industry’s only online, member-based networking community!

le Online Examp

New Customer Online Market Impact Program

FieldMedia has developed a special online-only offer to help you create a leadership presence on our member-based Web communities—CDHC Solutions Online and EmployersWeb.com Online—and help you generate sales leads, gain leadership presence, and connect you to our buyers and members.

Take advantage of our innovative online Who’s Who in Consumer-Directed Health Care profiles and receive the complete bonus package including lead-generating eblasts. Call your FM account rep 404.671.9551 or email at sales@fieldmedia.com. Check out the active online Who’s Who Profiles at www.cdhcsolutionsmag.com.

R e s o u r c e

If you use the services of our solutions providers, please tell them you saw their ad in CDHC Solutions™ or EmployersWeb.com™ magazine. Requests for Permissions to reuse content contact Copyright Clearance Center at info@copyright.com.

advertising contacts 404.671.9551

advertising index Aetna.............................................................................. 7

Empowered Benefits.............................................46

Aflac..............................................................................17

Envision Pharmaceutical Services...................49

AHIP...................................................................... 22, 49

FIS Healthcare Solutions.....................................10

Alliant Credit Union..............................................20

Health Care Reform Navigator........................45

Allstate.........................................................................51

InteliSpend Prepaid Solutions.........................38

CEO/Publisher Doug Field dfield@fieldmedia.com · ext. 101

AmeriFlex....................................................................47

Liazon...........................................................................49

BEMAS Software Inc..............................................48

Lighthouse1...............................................................47

Best Buy.......................................................................24

My HSA Rewards....................................................49

Associate Publisher Brent Macy bmacy@fieldmedia.com · ext. 103

Bravo Wellness........................................................40

Prime Therapeutics................................................32

CDHC Solutions Forum................................. 11-15

Restat............................................................................48

CDHC Superstars....................................................34

Transitions Optical................................................26

ConnectYourCare...................Inside Front Cover

Trotter Wellness....................................................... 5

DataPath................................................................8, 47

TSYS Healthcare............................................. 30, 47

DSS Research............................................................48

UnitedHealthCare.................................Back Cover

Vice President of Business Development Susan Yakots syakots@fieldmedia.com, ext. 102 Business Development Associates Rogers Beasley rbeasley@fieldmedia.com, ext. 109 David Cerri dcerri@fieldmedia.com, ext. 106 Reprints Drew Collins dcollins@fieldmedia.com, ext. 104 50

Gu i d e

March/April 2011 I CDHC Solutions™ I www.cdhcsolutionsmag.com

What’s Missing From Your Benefits Program? Allstate Benefits. We have the most comprehensive benefits portfolio in the business. Including the #1 critical illness product in America. It’s no wonder we’re one of the fastest-growing benefits providers in the country. Call an Allstate Benefits Representative today and let the Good Hands go to work for you.

You’re in Good Hands.®

1-866-895-8677 ® You’reorinallstateatwork.com Good Hands.

Life • Disability • Critical Illness • Accident • Medical Gap Sources: Allstate Benefits Internal Data 2010; LIMRA. Allstate Benefits is the marketing name used by American Heritage Life Insurance Company (Home Office, Jacksonville, FL), a subsidiary of The Allstate Corporation. © 2011 Allstate Insurance Company. www.allstate.com or www.allstateatwork.com

Engaging consumers to make informed health care decisions

UnitedHealthcare’s industry-leading consumer-driven health (CDH) plans were designed to get employees on the path to good health with improved lifestyle habits and use of the health care system. That’s why our plans offer: • 100% preventive coverage and personalized messaging based on individual health care needs • Easy-to-use resources for employees, including treatment cost estimators, Quicken HealthSM Expense Tracker, and Health Care LaneSM to help members understand and maximize their health care benefits • Banking through our own OptumHealth Bank, Member of the FDIC, oﬀering integrated access to account balances and a debit card that makes payments easier Tools like these help employees become active in their own health care decisions. We also oﬀer the employer ready-to-use tools to implement and successfully maintain its consumer-driven health plans.

For more information on UnitedHealthcare’s CDH plans, visit uhctogether.com/CDH or call 1.866.438.5651.

Grow Healthy.

©2011 United HealthCare Services, Inc. Insurance coverage provided by or through UnitedHealthcare Insurance Company or its afﬁliates. Administrative services provided by or through UnitedHealthcare Insurance Company, United HealthCare Services, Inc. or their afﬁliates. Health plan coverage provided by or through a UnitedHealthcare company. UHCEW506202-001